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Heavy periods are a common concern among women before menopause. The medical term for heavy menstrual bleeding is “menorrhagia”.
If you have menstrual bleeding so heavy that you dread your period, especially when your period have causes enough blood loss and cramping that you have to restrict your daily activities, talk to your GP or gynaecologist. There are many effective treatments for menorrhagia.
The common causes of heavy menstrual bleeding are:
In particular, seek medical help if you experience:
Depending on your symptoms and medical background, your GP may:
You may need to see a Gynaecologist when:
We will help you to work up the cause of heavy periods and to determine the best treatment strategy for you. Specific treatment will be tailored to the condition and needs of individual woman. It is based on a number of factors, including:
The followings are some examples of our treatment packages for menorrhagia. They may be used alone, in combination, or as part of a stepwise management strategy.
A pelvic ultrasound scan is one of the essential tests in many cases of menorrhagia. It is particularly useful to look for any abnormal growths in the uterus and ovaries, such as fibroids, polyps in the uterus, thickness of the uterine lining, and cysts in the ovaries.
In our consulting session, we offer real-time scanning so that the gynaecologist and patient can both look at the dynamic images at the same time and discuss the findings instantly. A treatment plan can then be formulated in the same consultation.
Alternatively, if you have already had an ultrasound scan arranged by your GP, please bring along your report and we can discuss the next treatment step based on the scanning result.
Medical treatment of menorrhagia can be in formed of:
We go through your current medications and adjust the dosage, or recommend a new regime according to your specific condition.
This treatment package will help you to:
You may be particularly suitable for this treatment package if:
Part 1- Diagnosis
First of all, the gynaecological surgeon performs a hysteroscopy to carefully look inside of the uterus. A hysteroscope is a tiny, slender camera that goes through the vagina into the uterus and produces a video image of the uterine cavity on the TV screen.
The surgeon will then obtain a biopsy at the lining of the uterus (endometrial biopsy), usually by a minor procedure called D&C. This is an important step to rule out cancer inside the uterus.
Part 2 - Treatment
Immediately after that, the gynaecologist performs one of the therapeutic procedures to reduce bleeding in the future:
These procedures may be done in the outpatient clinic, under regional anaesthesia, or after the patient being put to sleep (general anaesthesia). The decision is based on individual tolerance to specific procedures, previous vaginal birth, the likely cause of abnormal bleeding, and the planned therapeutic procedure.
Fibroids are one of the most common causes of heavy menstrual bleeding. Unfortunately, there are no medications that can effectively permanently shrink or completely get rid of the fibroids. The only way of removing the fibroids is by surgery. Myomectomy means surgical removal of fibroids (myoma is the technical word for fibroid).
Fibroids can be removed using minimally invasive procedures or traditional open abdominal surgery.
Most gynaecologists in Australia perform myomectomy using traditional open abdominal surgery. The surgeon makes a “bikini line” incision (called laparotomy, usually about 8-15cm) in the lower abdomen to gain access to fibroids. It is currently the most commonly performed method of myomectomy, in part because fewer doctors are skilled at the less invasive approaches and fewer medical facilities have all the necessary equipment.
At our practice, we have replaced open myomectomy with laparoscopic (keyhole) surgery in most of our patients. Laparoscopic myomectomy is a minimally invasive procedure where the surgeon makes tiny incisions (typically 0.5 – 1.0cm) on the abdomen to remove the fibroids from the uterus. The fibroids are then taken out with a device (morcellator) that efficiently cuts the fibroid into small pieces and allows for removal through one of the small laparoscopic incisions. Occasionally, a “mini-laparotomy” is performed in a similar fashion to open surgery but with a much small wound after laparoscopic myomectomy to achieve an efficient removal of large fibroids from the body.
If the fibroids are small ones inside the cavity of the uterus, they can be removed with hysteroscopy as described above.
Hysterectomy is surgical removal of uterus. It is the definitive cure of menstrual problems for women who have no desire for pregnancies in the future.. It offers an opportunity of improving quality of life and sex life, in particularly for women whose symptoms persist in spite of other treatments. It eliminates the chance that menstrual problems or new fibroids will recur.
Hysterectomy does not necessarily mean removal of ovaries. If women choose to keep the ovaries, they would still have normal hormonal cycles until the age of their natural menopause.
Same as myomectomy (see above), we are specialized in hysterectomy using minimally invasive techniques.
Every women is individual and her situation requires an individual plan of management. If you think these issues relate to you, arrange a personal consultation with us to discuss your menstrual issues and know more about our treatment programmes.
31 Bertram Street
Chatswood NSW 2067
1300 885 803
02 9475 0028
Dr. Sarah Choi