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Heavy menstrual bleedings

Menstrual bleeding or a period is a perfectly natural and very regular occurrence in a woman’s adult life. Nonetheless each woman’s flow is individual and entirely dependent on her. Even within the same woman the amount of blood lost with each cycle can vary greatly. The strict definition of normal blood loss with a period is 30ml. Therefore in theory we define 80ml loss as heavy. In practice however, the determination of a heavy period depends entirely on the individual woman. If her periods have previously been very light and suddenly become heavy or more frequent or incessant, this warrants investigation.There are many reasons for heavy or irregular menstrual bleeding:

  • Fibroids
  • Polyps (this video features the removal of a uterine polyp)
  • Cancers
  • Endometriosis and adenomyosis
  • Pregnancy related problems
  • Infections
  • Hormonal abnormalities
  • Coagulation disorder

 

Your doctor and Gynaecologist will explore these possibilities through blood tests, an ultrasound, a pelvic examination as well as an observation of your medical history. There are then two diagnostic procedures that may take place to find the source of the problem. A hysteroscopy involves inserting an endoscope (piece of medical equipment with a small camera and light) into the vagina to view the inside of the uterus. Then there is a laparoscopy where the endoscope is inserted via a small incision near the navel to view inside the abdominal cavity. 30% of cases of heavy menstrual bleeding are associated with conditions within the abdominal cavity.

Treatment

There are both surgical and medical treatment options in dealing with heavy menstrual bleeding, depending on the circumstances of the problem. Medical treatments may be as simple as the oral contraceptive pill or progesterone containing IUD (Mirena*), where surgical therapy will depend on the specific cause, the woman’s age and desires (e.g. future childbirth).

Surgical options include:

o   Curettage treatment or “clean out” (a scraping of the lining of the uterus)

o   Excision (removal) of all endometriosis in the pelvis

o   Removal of fibroids(myomectomy)

o   Endometrial ablation – microwave or laser to the cavity of the uterus to reduce or stop menstrual flow altogether

o   Hysterectomy

 

What do I do now?

A/Prof Reyftmann offers both advanced laparoscopic and hysteroscopic treatment of heavy bleedings. He would be happy to provide further information if desired. If you think these issues relate to you and you wish to organize a personal consultation please call 0242262844 to make an appointment.

 

Genea Accredited



Dr Reyftmann is a Genea Accredited Surgeon.
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