Heavy Menstrual Bleeding Should Be Checked to Verify It’s Nothing Serious

By Gynecology Specialists Staff

This month we’d like to talk with you about heavy menstrual bleeding. At some point in a woman’s life, she is likely to suffer from heavy menstrual bleeding. Heavy bleeding can be defined as excessive, prolonged or both. The medical term for this is menorrhagia.

The signs and symptoms of menorrhagia may include:

1. Menstrual flow that soaks through one or more pads or tampons in one hour or less for several hours consecutively.
2. The need to use a pad and a tampon or two pads to adequately control menstrual flow.
3. The need to get up and change a pad or tampon during the night.
4. Menstrual flow lasting longer than seven days.
5. Menstrual flow that includes large blood clots.
6. Heavy menstrual flow that interferes with your regular lifestyle.
7. Symptoms of anemia (tiredness/fatigue, shortness of breath, palpitations).

If any of the above signs or symptoms is affecting you, it is important to see your gynecologist. It is also necessary to see your gynecologist if you experience bleeding during or after intercourse, bleeding after menopause, or periods closer together than 21 days from the first day of one to the first day of the next bleeding episode. Gynecologists are not always able to determine the cause of menorrhagia, but it is important to rule out the potentially dangerous causes such as cancer.

Some of the many conditions that can result in heavy menstrual bleeding include:

1. Hormonal imbalance and/or lack of ovulation
2. Uterine fibroids
3. Polyps
4. Endometriosis
5. Adenomyosis
6. Certain medications
7. Thyroid disease
8. Pregnancy complications
9. Bleeding disorders
10. Pelvic inflammatory disease
11. Cancer

When you schedule an appointment at our gynecology clinic, you will be asked questions about your medical history, current medications, surgeries, pregnancies, and your menstrual history. You will also have a physical exam.

It is likely that you will have additional testing that might include:

1. Laboratory testing to check for pregnancy, anemia, thyroid disease, clotting disorders and/or a hormonal imbalance.
2. Pap smear to look for precancerous or cancerous cells on the cervix.
3. Vaginal ultrasound to look for uterine fibroids, polyps, thickened uterine lining, ovarian cysts or masses, or pregnancy complications.
4. Endometrial biopsy to assess the uterine lining for changes that can lead to cancer.
5. Sonohysterogram, which is a more extensive ultrasound that instills sterile water into the uterus. It is most often used to rule out uterine polyps.

Once the diagnostic testing is completed, your gynecologist will have a better understanding of what is causing your heavy menstrual bleeding. Then a plan can be made for how to best treat the problem. The treatment options will vary greatly depending on the diagnosis.

Some possible treatment options include:

1. Hormone therapy with oral contraceptives, hormone replacement therapy or an IUD
2. Thyroid medication
3. Anti-inflammatory medication
4. Uterine fibroid embolization
5. Hysteroscopy with D&C
6. Fibroid resection or polyp removal
7. Endometrial ablation or Cryoablation, “Her Option”
8. Hysterectomy
9. Lysteda nonhormonal medication

If all of the diagnostic testing is negative, and the heavy menstrual bleeding is proven to be a benign abnormality, the endometrial cryoablation or “Her Option” procedure may be a great alternative. This procedure is done in our gynecology clinic without any incisions or general anesthesia. Medication is given to relax the patient, so a driver is needed.

The cryoablation essentially uses sub-zero temperatures to destroy the lining of the uterus. It has an 80% success rate in which the patients either bleed much less or not at all after the procedure. Most women are back to their normal routine the next day. There are women for whom this procedure is not the best option, so it is important to talk to your gynecologist about your heavy menstrual bleeding today.

If you are suffering from heavy menstrual bleeding, menorrhagia, or hormonal imbalance, please contact our gynecology clinic at (757) 312-8221. Our gynecologists are here to help you.