Drug Therapy
Medication can be prescribed to treat women suffering from menorrhagia, such as a low dose birth control pill or ongoing hormone therapy. Other drugs that can be prescribed to treat the condition include Tranexamic acid and Danazol. However, women can experience adverse side effects as a result of using these medications such as bloating, nausea, weight gain, headaches, depression and mood swings.
<<Back to top
Hysterectomy
A hysterectomy, the surgical removal of the entire uterus, is a medical procedure that provides a definitive cure for menorrhagia. However, it is important to always weigh up other options available and to view a hysterectomy as a last resort procedure.
A hysterectomy is major surgery which requires general anaesthesia, several days in hospital and a recovery time of approximately six weeks. In addition to the lengthy recovery time and the actual trauma of removing the womb, women who undergo a hysterectomy commonly require a prolonged course of hormone replacement therapy (or HRT) due to the hormonal imbalances that result as a consequence of the removal of the uterus.
<<Back to top
Dilation & Curettage (D & C)
Often used in conjunction with drug therapy when drugs alone are not effective for the patient, Dilation & Curettage (D&C) is a 15 to 30 minute surgical procedure that involves the contents of the uterus being removed via a vacuum aspiration.
A D&C does not provide an immediate cure for menorrhagia, it may reduce bleeding over the course of a few menstrual cycles, but the procedure must be repeated periodically to be effective. As a result, the patient is susceptible to a number of risks each time the procedure is performed like uterine penetration, infection and the complications of taking a general anaesthetic.
<<Back to top
Intrauterine
Progestin Therapy
Intrauterine progestin therapy, commonly referred to as a ‘Mirena IUD’, is a hormone-releasing intrauterine system that can be fitted during an outpatient appointment or under general anaesthetic.
Women also have the option of using Mirena as a contraceptive, with the treatment providing the user with five years of contraception, once in place. Although Mirena has proven effective in reducing heavy bleeding, a negative side effect is that it often results in erratic vaginal bleeding or spotting, particularly during the early months of use.
<<Back to top
Uterine Balloon Therapy
Uterine Balloon Therapy is a surgical treatment that involves the vaginal insertion of a balloon catheter through the cervix and into the uterus. The balloon is inflated with sterile fluid, which in turn is heated by an element inside the balloon. The temperature of the balloon is commonly raised to approximately 87° C, which is maintained for about eight minutes.
Thermal ablation of the uterine lining results from intimate contact of the endometrium with the heated balloon. However, often the balloons do not conform well to the corners of the uterine cavity and these areas can also be the coolest parts of the balloon. As a result, residual pockets of endometrial tissue can be left causing continued bleeding and pain.
<<Back to top
First-Generation Endometrial Ablation (Hysteroscopic Endometrial Ablation)
Endometrial ablation is a minimally invasive treatment option for menorrhagia that preserves the uterus and is suitable for women who have completed childbearing. First- generation endometrial ablation treatments require visualisation of the uterus with a hysteroscope and, although safe, require skilled surgeons.
These include
Transcervical Resection of the
Endometrium (TCRE) and
Rollerball Endometrial Ablation (REA). It is common for surgeons to combine these two treatments, using REA to ablate the uterine fundus and corneal regions and TCRE to cut out strips of the underlying muscular layer from the walls of the uterus.
First-generation endometrial ablation techniques are well regarded in countries like the UK and the US, with TCRE and REA proving to be both a safe and effective method to treat women suffering from menorrhagia.
However, there are also a number of disadvantages associated with first-generation endometrial ablation treatments. They can result in serious complications like fluid overload, perforation, gas embolism and haemorrhage and also require a high level of surgical skill.
<<Back to top
Second-Generation Endometrial Ablation (Thermal Endometrial Ablation)
Second-generation endometrial ablation treatments are simpler and faster than first-generation treatments and do not require visualisation of the endometrium. The majority of techniques use various forms of energy to create tissue heating, which results in endometrial destruction.
The key advantages of thermal endometrial ablation procedures is that they can be performed by a greater range of physicians and women are also exposed to far less risk in comparison to first-generation treatments. Although, some thermal endometrial ablation treatments have been found to result in reduced effectiveness and fail to maintain long-term, positive clinical results for patients.
Microwave Endometrial Ablation (MEA) is the latest second-generation endometrial ablation treatment available for sufferers of menorrhagia. Pioneered by UK medical research company Microsulis, MEA uses high frequency microwave energy to cause controlled and rapid heating of the endometrium, causing it to come away and preventing its re-growth.
According to Microsulis, MEA has been shown to stop heavy menstrual bleeding altogether in 61 per cent of women in clinical trials, and produces satisfactory results in 96 per cent. The balance also have totally acceptable levels of success, as shown in the FDA trials.
In comparison, trials in uterine balloon treatment typically report only a 13 per cent success rate.
MEA offers significant benefits to women suffering from menorrhagia, compared to other methods of endometrial ablation. The treatment time is very fast, with the average procedure completed in about 3.5 minutes. With MEA, the costs of the initial procedure and future procedures are also lower due to the fact that very few complications of surgery have been recorded and rates of further surgery are extremely low.
Most importantly, MEA is very patient-friendly, with women reporting minimal discomfort and a very fast recovery time. This ensures that sufferers will get back on their feet, leading a normal life again as soon as possible.
<<Back to top
