Between 5 and 10 percent of all U.S. women complain to their doctors about AUB, which affects more than 10 million annually. AUB is defined as menstrual loss of more than 80 mL. This translates to menses that continues for more than seven days or the use of more than 10 pads or tampons per day. It is most commonly associated with perimenopause.
AUB can cause chronic anemia, pelvic pain and cramping. The condition also severely impacts quality of life by disrupting work, social functioning and family life.
AUB can have hormonal or non-hormonal causes. Uterine fibroids, or myomas, are a common non-hormonal cause. Clinically, there are three main types of myomas, classified according to their location in the uterus:
- Intramural myomas grow within the uterine wall.
- Subserosal myomas develop in the outer portion of the uterus.
- Submucosal myomas grow just under the lining of the uterine cavity and near the endometrial cavity.
It’s this last group of myomas, the submucosal, that have the most effect on AUB. Because of their location on the endometrium, these myomas place pressure on the uterine lining that builds with each menstrual cycle. This, in turn, can cause heavy bleeding. Even very small submucosal myomas may cause very heavy bleeding.
Endometrial polyps are another non-hormonal cause of AUB. These hyperplastic overgrowths of glands and stroma form a mushroom-like fold that projects into the uterine cavity. They can be single or multiple growths.
Hysteroscopic fibroid removal is one of the most effective treatment option, delivering several advantages over conventional techniques for the removal of submucosal myomas and endometrial polyps.
Approved by the FDA in 2004, Hysteroscopic fibroid removal uses a probe with a “uterine shaver.” Once placed inside the uterine cavity, the device shaves off and immediately suctions out any excised tissue that might impair visibility. The ability to remove and instantly suction out tissue fragments means the hysteroscope and fibroid removal instrument are inserted only once, for initial entry. This is a huge advantage from both the physician’s and the patient’s point of view.
In addition, in 2018 we are proud to offer in-office uterine polyp removals. For the patient, this means there is no need for general anesthesia and a quicker recovery.