Being More Comfortable at the Doctor’s Office

Posted on: 22 March 2022

Does your menstrual cycle seem like it's really off? Abnormal uterine bleeding affects 10 to 30 percent of pre-menopausal women, according to a research review published in the journal of the American Academy of Family Physicians (AAFP). If you're experiencing this common issue, take a look at what you need to know about the treatment of abnormal bleeding and the surgical options.

What is Abnormal Bleeding?

Before you start treatment, you need to confirm that you have abnormal bleeding—and not just a slightly shorter menstrual cycle or longer (but normal) period. Abnormal menstrual bleeding may include bleeding in between periods, spotting in between periods, excessively heavy bleeding (soaking through at least one tampon/pad every hour), menstrual cycles that are longer than around 35 days, or cycles that are shorter than close to 21 days.

If you have any of these symptoms, contact your OBGYN. The gynecologist will review your health history, ask you questions about your menstrual cycle, examine you, and may order diagnostic tests. After the doctor diagnoses you with this condition, you are ready to take the next step and talk about treatment options.

Is Surgery the Only Treatment?

There are medical and surgical treatments for abnormal bleeding. Medical treatments include hormonal birth control pills, non-steroidal anti-inflammatory drugs (NSAIDs), gonadotropin-releasing hormone antagonists, and gonadotropin-releasing hormone agonists. While medical options can reduce or even eliminate the symptoms in some women, others may need an invasive abnormal bleeding treatment. Symptoms that don't respond to medical treatment options, are severe, or have some types of known causes (such as uterine fibroids) may require a surgical intervention.

What Types of Surgical Options Are Available?

The most common invasive (surgical) procedures used to treat abnormal uterine bleeding include uterine artery embolization, myomectomy, and endometrial ablation. Some serious causes of uterine bleeding, such as reproductive system cancer, may require a hysterectomy. 

What Happens During Surgery?

The answer to this question depends on the type of surgery that you need. A hysterectomy is the full removal of the uterus. Again, this type of procedure is not always necessary and is used in severe or serious circumstances/cases. Instead of removing your uterus to stop the abnormal bleeding, your OBGYN may recommend a:

• Uterine artery embolization. You may need this procedure if you have fibroids. An embolization uses a catheter and tiny plastic or gel particles (fed through an artery in your leg) to cut off the fibroids' blood supply.
• Myomectomy. Also used to treat fibroids, this procedure is the surgical removal of uterine masses. 
• Ablation. The surgeon will remove a thin layer of tissue from the lining of the uterus using cold, microwaves, electricity, heated fluids, or radio waves.

The type of procedure you may need depends on factors such as the severity of the bleeding, the cause, and your overall health.