What are the treatment options for excessive bleeding?

Excessive bleeding during menstrual periods can be defined by either the volume of blood loss or the duration of the bleeding. Typically bleeding of more than 80 ml (more than 5 tampons or pads per day) or bleeding for more than 7 days is clinically categorized as excessive bleeding or Menorrhagia. Treatment is determined by the conditions effect on the patient’s lifestyle and underlying cause.

Some of the causes are:
• No identified abnormality
• Hormonal imbalance (especially involving the ovaries)
• Fibroids
• Coagulation disorders
• Cancer of the uterine lining
• Polyps within the uterine
• Pelvic inflammatory disease (PID)
• Endometriosis
• Adenomyosis

If treatment is necessary it can range from drug therapies to manage hormone level to the surgical removal of the uterus (hysterectomy). A minimally invasive alternative to a hysterectomy is called Hydro-thermal Ablation (HTA). One of the few Ob Gyn practices in the Salinas and Monterey County area to offer HTA is Health Care For Women adjacent to the Salinas Valley Memorial Hospital.

Since HTA can be performed as an outpatient without any surgical incisions, it usually takes only about 30 minutes. The procedure can be done with local anesthesia with some sedation, and the patient can resume normal activities within 24-48 hours. The procedure consists of inserting a small device (hysteroscope) into the uterus, sealing the cervix and filling the uterus with saline (salt water). Using the hysteroscope, the fluid in the uterus is heated to destroy the lining and eliminate or reduce menstrual bleeding. The uterus is then rinsed with room temperature saline to complete the procedure.

An important consideration before receiving HTA is the decision that the patient has completed their family and does not anticipate any future pregnancies. Although the procedure does not prevent pregnancy, any conception after the ablation of the uterine lining must be treated as high risk and may result in miscarriage. After the procedure, it is highly recommended to ensure effective birth control or sterilization such as insertion of Essure to prevent potential complications of post-HTA pregnancy.

For more information regarding abnormal menstruation, including excessive bleeding, irregular bleeding, bleeding after menopause or other Salinas ObGyn or Monterey ObGyn care, call Health Care for Women in Salinas, California or go to hcfw.com.
To make an appointment with an expert women’s health professional to discuss obstetrics or gynecology concerns, healthy pregnancies or general women’s healthcare, please call 831-758-8223.

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