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Time of the Month

01/31/2009 04:00PM ● Published by Super Admin

Women have more options, and there are fewer hysterectomies these days as a result of the many alternatives available to them,” according to Dr. Denise L. Sweeney, M.D., F.A.C.O.G, who practices at Associates in Women’s Health Care in Roseville. “Women are fortunate [to have] these new treatments, that free them up, with very little down time,” says Dr. Sweeney.

An estimated 20 million American women have had a hysterectomy. One-third of American women experience some type of pelvic health disorder by the time they are 60, and many have a hysterectomy, which is removing their uterus to relieve troubling symptoms. Women with painful periods, excessive bleeding, fibroids, endometriosis or other pelvic health problems will find comfort in learning that there are new alternatives to consider.

Treating Uterine Fibroids
Uterine fibroids are tumors that are usually benign and are found on the smooth muscles of the uterus and can cause pelvic pain, infertility and heavy menstrual bleeding. Their cause is complex, but uterine fibroids are a major reason why women have hysterectomies.  If fibroids are causing no symptoms, it’s common to monitor the status with your doctor and wait to have surgery unless problems develop. There are less invasive options for treating fibroids:

A Myomectomy is the surgical removal of the fibroids alone. A Uterine Artery Embolization (UAE), also known as Uterine Fibroid Embolization (UFE), is a fairly simple, noninvasive procedure in which small particles are injected into the uterine arteries feeding the fibroids, cutting off their blood supply. It’s been used for years to help stop hemorrhage after childbirth or surgery, however, there is a risk of early menopause if those particles travel to the ovarian blood supply. With this treatment, symptoms are reported to improve in 85 percent of patients.
A hysteroscopy is a minor surgical procedure with minimal recuperation time. It is the insertion of a thin telescope like instrument, called a hysteroscope, and can be used if the fibroid is primarily within the cavity of the uterus. Medical management is a way to initially treat painful symptoms with non-steroidal, anti-inflammatory agents. If that is not effective, another option is a class of drugs that blocks the ovaries’ production of estrogen and other hormones.   

Treating Menorrhagia
Severe vaginal bleeding is known as menorrhagia. The bleeding may come from uterine fibroids, but in many cases the cause remains unknown. Doctors have a medical threshold for menorrhagia, but they also define it by how much it affects your daily life by causing pain, mood swings, and disruptions in your work and sexual activity. The treatment options are medical management, using either oral contraceptives or an intrauterine device (IUD) releasing a hormone called levonorgestrel. Endometrial ablation is an option if you don’t plan to have more children. “This is an excellent option, can be done in the office and 80 percent of women will never have another period,” Dr. Sweeney adds.

It is possible that whatever your condition is, a hysterectomy may be the most effective treatment. But, with the many new alternatives available, it is important to discuss all of your options with your doctor. Abnormal bleeding can be the first sign of uterine cancer and therefore should not be ignored. The positive news is that most hysterectomies can now be done with minimally invasive techniques and only an overnight hospitalization, if the alternatives are not an option.

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