Heavy Periods Recurrent Pregnancy Loss

If you have HEAVY PERIODS, please read on this pamphlet Mayble you are suffering with dysfunctional uterine bleeding and we can help you without uterus removal

More than 1 in 5 women in their 30s and 40s suffer from heavy periods. Heavy periods can be very frustrating both for house wife & working women. One has to think twice about wearing light-colored clothes during periods. The pain and cramping in lower abdomen is very annoying. And sometimes this bleeding drags on longer than a week or more. One is in dilemma how to deal with it for quality personal life, family life and how to avoid frequent leaves from work place.

There are various causes for heavy bleeding. In good 20% patients with heavy bleeding uterus is of normal size, but bleeding is very heavy & unmanageable

Q. When do you say that you have heavy period?

A- When there are symptoms of unmanageable bleeding, clotting, flooding and a constant need to change pads or tampons. Mainly it is your perception regarding deviation from your normal.

Q- What is DUB?

A- DUB is excessive bleeding per vaginum which is not associated with any tumor or cyst in uterus, ovaries and falloplan tube.

Q- How is it diagnosed?

A- Your doctor will take thorough history, do a complete examination, perform relevant lab investigation, pelvic ultrasound, sometime hysteroscopy and an endometrial biopsy before making the diagnosis of DUB or organic cause of Heavy bleeding.

Q- Is it dangerous to my health?

A- In a way, yes. It will trouble you in the form of growing tiredness due to Anaemia breathlessness with your day to day working and will have definite impact on your sexual life. You might have to take frequent leave from work please

Q- What are the treatment options? Do I need to get my uterus removed

A- Not at all, in fact in today’s word uterus removal (hysterectomy) is really the last resort with normal size or bulky uterus. Choice of treatment is decided depending on patient’s age, severity of bleeding and need to retain fertility.

Q- Then what are the various treatment modalities available?

A- Your doctor can either put you on medical treatment in the form of drugs where are effective in one third cases. However the latest in the treatment is global endometrial abortion procedure (destruction of lining of uterus) and insertion of MIRENA (an intrauterine device containing levonorgestrel)

Q- What exactly is Global endometrial ablation?

A- Global Endometrial ablation is a process in which the endometrium (innermost lining of uterus) is destroyed by various methods. The common ones being THERMAL BALLOON ABLATION and TCRE.

Q- What exactly is uterine balloon therapy?

A- It is 10 minutes solution for heavy period.This is a simple, safe and successful procedure in which a disposable balloon is passed into the uterus and the endometrium is destroyed by raised fluid temperature in the balloon. The process is fully computerized

Q-Does it work?

A- Yes. More than 600,000 people around the world had been treated with Uterine balloon therapy technique up to December 2005. Clinical studies over 10 years have shown it to be a reliable and very effective treatment in good 95% women. In fact, gynaecologist allover world use various endometrial ablation techniques with almost similar results. With proper selection of cases, (i.e. excluding cases of fibroid uterus and uterine cancer,by ovarian cysts) the results show 97-98% success if woman enrolled are well selected.

Q- What about fertility & contraception?

A- One should not have this treatment if one wants to become pregnant in future.

Q-Is it covered by MEDICLAIM?

A- .This is not cheap but very patient friendly procedure. It is covered under mediclaim (Health Insurance Schemes) in India and this facility is available in over five hundred hospitals of the country.

Q- Can you tell us more about Balloon therapy procedure?

A- The new techniques of uterine balloon therapy has made the management of heavy menses simple, safe and quick. The uterine balloon ablation therapy involves the insertion of a small tube with an inflatable balloon at the top into the womb through the vagina. There are no cuts or stitches required for this. The procedure can be done under light anesthesia, and is safe even for patients who have medical problems such as uncontrolled diabetes, high blood pressure, blood cancer, heart or kidney disease like kidney failure, where major operations are risky to perform. It results either in permanent stoppage or marked reduction in menstrual bleeding, and is therefore this procedure is very good for women who have completed their family. The patient needs to be in the hospitals for only few hours and does not need to rest at home after the procedure. She is fit to resume work the next day, unlike in major surgeries where the recovery time is longer (i.e. 6-12 weeks).

Q- What if the drugs have failed and I do not want to undergo any surgical intervention?

A. For you, MIRENA is the answer. It is an intrauterine device which is effective for 5 years with added advantage of contraception and your fertility remains intact after removal. The amount of bleeding decrease in all. However full effect of MIRENA is seen after 3 months of treatment with MIRENA. The effect is not immediate for this patient as to be counselied.

Q- What about uterus removal, if I do not want a child?

A. Yes, if you have tumors in uterus or ovary, then you have NO other choice but to remove the uterus. Uterus removal for normal size uterus is too major a procedure. It should not be taken lightly. As risk to life is 2/1000 hysterectomies & another 25% have minor complications like UTI etc.

Q what is this open or Laparoscopic surgery?

A. Choice is of surgery depend on surgeon & your examination finding & associate medical problems & any previous surgeries, whether uterus removal can be done by open technique or by laparoscopy.