Heavy mentrual bleeding

Did you know that one in five women suffer from heavy periods and many go through life without ever taking action? For some women, their periods tend to get heavier over time, particularly in their late 30s and into their 40s. Some suffer all of their lives thinking heavy periods are normal.

Heavy periods deserve evaluation, for your health and well-being.

Heavy menstrual bleeding may be caused by several different conditions. Thyroid problems, uterine fibroids or polyps, perimenopausal hormonal changes, pre-cancerous changes of the uterus and other factors may lead to heavy bleeding with your period.

Depending on the duration and severity of the problem, and other details of your experience with heavy bleeding, the diagnostic workup may vary. Your physician may recommend blood tests for thyroid problems or anemia. A pelvic ultrasound will help evaluate for uterine fibroids, ovarian problems, and structural problems. A fluid-contrast ultrasound (also called sonohystogram, or SHG) is very helpful for evaluating the lining of the uterus for structural abnormalities such as polyps and fibroids. An endometrial biopsy may be recommended to make sure that there are no pre-cancerous changes in the uterine lining.

Pelvic ultrasound: This test is performed in the office and is painless. Ultrasound is used to take pictures of the pelvic organs. Transvaginal ultrasound uses a small probe placed just inside the vagina to take clearer pictures of the uterus and ovaries. It is not necessary to have a full bladder for this type of ultrasound.

Fluid contrast ultrasound: Done in the office, this procedure allows us to see the inner contours of the uterus, and to identify polyps or fibroids. A small, flexible catheter is passed through the vagina and cervix, and sterile saline is used to gently expand the uterus. An ultrasound is then done, to take pictures of the uterine lining contours. A patient may experience mild cramping with this diagnostic procedure.

Endometrial biopsy: This office procedure is done to evaluate the lining of the uterus for pre-cancerous or cancer cells. A thin catheter is passed through the vagina and cervix into the uterine cavity, and mild suction is used to obtain a sample of the lining tissue. The patient may experience brief cramping during this procedure.

What can be done to improve heavy menstrual bleeding?

In the past, hysterectomy was the definitive treatment for heavy periods. We now have less invasive options available for managing uterine bleeding. These procedures may be done in our office or as outpatient day surgery, and do not require hospitalization.

Hysteroscopic morcellator: If fibroids or polyps in the uterus are causing heavy bleeding, they may be removed using hysteroscopy--a scope through the vagina and cervix into the uterus, which doesn't require any incisions. New and innovative instruments, such as the hysteroscopic morcellator, allow the safe removal of polyps and fibroids while preserving the uterus, ovaries, and normal hormone function. For more information on the morcellator, click here.

Endometrial ablation: In this procedure, the uterine lining tissue is treated directly with hot or cold energy, to reduce the cyclic thickening and shedding of the lining that causes heavy bleeding. This technique preserves the uterus and normal hormone functioning, but can substantially reduce, or even stop, menstrual bleeding. This procedure may be done in the office setting, with minimal discomfort. Recovery times for patients are rapid and allow a quick return to normal activities. For more information on endometrial ablation, click here.

If your periods are interfering with your life, make an appointment (303.444.5110) to talk to one of our physicians about your periods. At Boulder Women's Clinic, we focus on providing you the most appropriate solution to your bleeding that best fits your lifestyle and needs. Now you can take control of your life!