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Evaluation of Abnormal Bleeding |
Abnormal periods usually can be divided into hormonal causes and structural problems. Hormonal causes are common in teens and perimenopausal women. These problems occur in women with a normal uterus and can usually be managed with correction of the underlying hormonal problem. This may mean periodic hormone supplements, or perhaps the use of birth control pills. Hormonal problems may be a one time problem, or may require recurring treatment.
Women with structural uterine problems will usually be detected by examnination or by sonography. The most common problems are uterine fibroids and polyps within the lining of the uterus.
Treatment of these problems depends on the goals of the individual woman. Hysteroscopy can remove polyps and some uterine fibroids. Either laparoscopic or open abdominal surgery can remove fibroids deep in the muscle of the uterus. If childbearing is complete and a final solution is desired, laparoscopic supracervial hysterectomy can be performed with minimal pain. Hospital time is either day surgery or one night stay. Return to work is within 2 weeks. Sex can be resumed at 2 weeks as well. This new innovation in hysterectomy should be offered to all women requiring hysterectomy.
Uterine Artery Embolization is a procedure perfomed by the Radiologist. In this procedure very 12pt spheres are injected into the uterine arteries to attempt to starve the fibroids of blood flow. Reduction in size of fibroids is accomplished. Symptoms improve, but new fibroids may grow until menopause. Pregnancy is possible after this procedure, but would be considered high risk.
Endometrial ablation is a procedure which attempts to destroy the bleeding part of the uterus. The procedure is performed in day surgery through the vagina. Success is somewhat variable but most women will either have no more periods or have their bleeding reduced to a few days of pantyliners.
Treatment of abnormal bleeding needs to be individualized, and thoroughly evaluated before deciding which option is right for you. We offer and are experienced at all options for treatment. |
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