MENORRHAGIA AND TREATMENT OPTIONS

Michael Counce, M.D.What is Menorrhagia?  Menorrhagia is defined as unusually heavy and/or long-lasting menstrual periods. If your period lasts a long time, or is so heavy that you need to change pads or tampons every one to two hours, then you may have menorrhagia.

New outpatient surgical options are now available which can be done in the office with minimal downtown and only require intravenous sedation as opposed to general anesthesia, but first- do you suffer from menorrhagia?

Consider the following:

  1. Do your periods last a long time?
  2. Is your bleeding so heavy you need to change your pad or tampon every one to two hours?
  3. Do you often wear a tampon and a pad for more protection?
  4. Do you need to change your pads at night, or do you stain your sheets?
  5. Do you pass many clots? Are your clots sometimes as large as a quarter?
  6. Are you tired all of the time?
  7. Do you wear dark clothing because you worry about having menstrual accidents?
  8. Does your bleeding affect your work, social, athletic, or sexual activities?
  9. Would your life improve if you had less bleeding or no bleeding each month?

If you answered “yes” to any of these questions, then you may have menorrhagia.

How common is menorrhagia?

Menorrhagia occurs in one out of every six women. An estimated ten million women suffer from heavy menstrual bleeding; yet only 2.5 million seek treatment each year. The reason for this is that many women are embarrassed to discuss their periods. They think their bleeding is normal because it has always been that way, or they are afraid of the treatment options.

Heavy bleeding is a problem for many women at different stages of their lives, including women who have had a tubal ligation (had their “tubes tied”) or are approaching menopause. These events may cause changes in a woman’s bleeding. Your doctor can help you determine whether you may be suffering from menorrhagia.

What are the effects of menorrhagia?

Physical: The physical effects of menorrhagia may include heavy periods that last more than a few days; heavy bleeding that requires double protection, large blood clots, severe cramping, fatigue, anemia, headaches, and nausea.

Social: Menorrhagia is more than just a physical condition. Women are often forced to plan their lives around their heavy periods. More than 60% have had to miss social or athletic events. Approximately 80% avoid sexual activities and 33% have been forced to miss work.

Emotional: Menorrhagia can disrupt the lives of women in other ways as well. Among women with heavy periods, 77% experience depression or moodiness, 75% feel anxious, and 57% feel a lack of confidence.

Outpatient office surgery treatment option:

Endometrial ablation is a one-day treatment option designed to end heavy menstrual flows by destroying the lining of the uterus, available for women with benign menstrual bleeding who are premenopausal and have completed childbearing. Unlike hysterectomy, which takes out the entire uterus, the device used in ablations only treats the lining of the uterus with heat.

The procedure involves dilating the cervix, taking certain measurements of the uterine cavity to be sure you are a candidate (cavity assessment), and then introducing the device and applying the heat to approximately 87 degrees Celsius for a period of 90 seconds to eight minutes, depending upon the device used. The device is then removed and discarded. After a 30-60 minute recovery period, you are usually free to go home, take it easy for the day, and return to normal activity within a few days. The uterine lining will slough off in the next 7-10 days. Within a few months you will generally know what your baseline bleeding will be. A large percentage of women will experience no further menstrual periods, others will have it greatly reduced, and approximately 2% will experience no change in bleeding and need to consider other options such as hysterectomy.

 

Michael Counce, MD
Memphis Obstetrics & Gynecological Association, PC (MOGA)