Finding Relief For Abnormal Uterine Bleeding
Research and Innovations Menstruation is a regular part of being a woman, but experts warn that your “time of the month” should not require taking time out from regular life.
“You should not be living with heavy menstrual bleeding that prevents you from living your life — prevents you from doing leisure activities, work activity, or spending time with your family,” says Dr. Ally Murji, a gynecologist working at Mount Sinai Hospital and Women’s College Hospital. “If the heaviness or pain with your period is affecting any of those, then that’s considered abnormal.”
An estimated 30 percent of women will seek medical help for abnormal uterine bleeding during their reproductive years, according to The Society of Obstetricians and Gynecologists of Canada.
What is “abnormal”?
Women typically menstruate, shedding their uterine lining, once every month — resulting in approximately a week of vaginal bleeding. Patients who experience abnormal uterine bleeding may have their period for longer than seven days, painful cramping, and bleeding so heavy that they cannot do daily activities.
“I think the patient’s experience is probably the most important factor in figuring out whether the patient needs help,” says Dr. Sony Singh, the vice-chair of gynecology at The Ottawa Hospital. He adds that other symptoms of excessive bleeding — previously termed “menorrhagia” — include chronic fatigue, inability to focus, difficulty sleeping, and low iron counts.
“Ablation is probably the most significant advancement in gynecological procedures that I’ve seen in my 20 years.”
“Many of our patients don’t even want to leave the house for fear of having a heavy menstrual bleeding episode — soiling their clothes or being at work and trapped without any pads or tampons,” says Singh.
Murji’s has seen executives worried about staining their clothes or chairs during work meetings or flight attendants who don’t fly during their period. “It really has a profound impact on patients quality of life and just general productivity,” he says.
What can be done
When it comes to abnormal uterine bleeding, the solution is determined by the cause of the condition.
Heavy bleeding is result of either hormonal abnormalities, where a woman is not releasing an egg (ovulating) every month, or anatomical abnormalities, such as fibroids, polyps, or an enlarged uterus, explains Dr. Andrew Browning, a gynecologist at the Royal Victoria Hospital in Barrie.
“If the problem is primarily hormonal, then usually medication will solve it,” he says. “If the problem is mainly anatomical, then often surgical solutions are what it takes.”
Though surgery can sound scary, this condition can now be treated with numerous different procedures, many which are minimally invasive.
“In the past the hysterectomy was a way to just remove the whole uterus as the problem, but now we can actually specifically address the issues — whether they be a polyp, a fibroid, or a bleeding disorder,” says Singh.
One example of a targeted surgical solution is called endometrial ablation, a simple procedure that can be done in an operating room or, as is becoming more common, a clinic setting.
During this quick, outpatient procedure — which is only performed on patients who have no desire to become pregnant in the future — a physician destroys or removes the endometrial layer of a woman’s uterus.
With the prevalence of abnormal uterine bleeding, the technology involved with endometrial ablation techniques has advanced significantly in the past decade to the point that in some cases it can be completed in less than two minutes.
“This is a 90 second procedure that has significant impact on a patient’s life and improvement in their quality of life,” says Murji, explaining that the patients do not need to be under general anesthetics for the procedure, can return home right after, and are often back to their daily activities within 24 to 48 hours.
According to Browning, he has seen “immense changes” in patients who have had endometrial ablation —a procedure with an overall patient satisfaction rate of more than 90 percent.
“Ablation has profoundly reduced the need for hysterectomy,” he says. “[It] is probably the most significant advancement in gynecological procedures that I’ve seen in my 20 years.”
Experts agree that heavy bleeding is not something women have to suffer through and live with on a regular basis.
“It’s an extremely treatable condition that can often be solved with either medications or a very simple surgical procedure that has an extremely low complication rate and a very high satisfaction rate,” says Browning.