Control Heavy Bleeding

If heavy bleeding each month is disrupting your daily activities, you don’t need to live with that. Women who experience heavy menstrual cycles have several options – including one that burns or freezes the lining of the uterus – that will reduce the bleeding, says Dr. Madhav Boyapati, a board-certified obstetrician/gynecologist at the Woman’s Clinic.

Physicians call the heavy menstrual bleeding “menorrhagia,” a condition usually caused by irregular hormones, uterine fibroids or polyps on the uterine wall, Dr. Boyapati says. As many as one in five women suffer from menstrual bleeding that is too frequent, too long or too heavy.

“Excess bleeding is subjective,” he says. Usually, though, it is defined as lasting longer than seven days, having less than 21 days before the start of your next period, or having bleeding so heavy that you limit your activities during your period.

Besides causing women to limit their activities, heavy bleeding can cause menstrual cramping, fatigue and anemia. “Excessive menstrual bleeding disrupts a woman’s normal life,” Dr. Boyapati says.

After getting a medical history and doing a physical exam, Dr. Boyapati will offer several options of treatment, depending on your age, your health, and whether the easiest options correct the problem.

  • Since irregular hormones are often the culprit, taking birth control pills or hormone therapy often will regulate the bleeding and lessen the flow of blood, solving the problem for many women.
  • If you are over 35, the abnormal bleeding could be a sign of precancerous polyps in the uterus or even uterine cancer. “This is not picked up by a Pap smear,” Dr. Boyapati says. An ultrasound, usually done in the doctor’s office, can detect if polyps inside the uterus are causing the bleeding, he says. “Most polyps are not precancerous.”

If he finds polyps in a patient over 35, he says he likes to go ahead and do a biopsy that day to check for cancerous conditions.

If the polyps show no sign of cancer, he again has several treatment options…

  • The patient can try hormone therapy. Not all women, however, can take birth control pills. The pill can increase the risk of heart attack or stroke if you already have high blood pressure or diabetes or if you are a smoker older than 55.The patient can opt for ablation, an outpatient treatment that burns or freezes the lining of the uterus, making the lining thin so there is not so much bleeding. Most women will then have a normal menstrual flow, though some will have little or no flow after the procedure. Ablation also reduces your ability to become pregnant.
  • A final option is usually a hysterectomy, the surgical removal of the uterus. When possible, Dr. Boyapati will do a laparascopic-assisted hysterectomy to make the surgery less invasive and reduce the recovery time for the patient.

More women these days are opting to have the ablation, says Dr. Boyapati. “It’s a relatively new procedure. New methods make it easier for the woman and offer more safeguards.”

The Woman’s Clinic was the first in the area to offer cryoablation in the clinic setting. No general anesthesia is required. Dr. Boyapati uses a slender probe inserted through the vagina to freeze the lining of the uterus. The procedure takes 20 to 30 minutes. Most women return to normal activities the next day.

“Nearly all women who have had the cryoablation are pleased and will recommend it to others,” Dr. Boyapati says.