Surgical options for heavy menstrual bleeding

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Women who suffer from heavy menstrual bleeding now have treatment options they might not be aware of, says a leading Gold Coast gynaecologist. 

Many put up with debilitating periods that severely affect their lives for years, but a trip to the doctor could provide a solution.

"These women often call in sick to work, end up bed-bound, avoid the gym or leaving the house, and some, alas, perceive that this is the norm,” said Gold Coast Private Hospital surgeon Dr Graeme Walker. 

"There are many steps to treating heavy painful periods, many of which can be undertaken by the GP, including simple medications which can reduce the amount of blood lost during the period by up to 50 percent,” he added.

Also, Dr Walker said the combined oral contraceptive pill could help younger women in particular, while the Mirena intrauterine device – inserted into the womb – can significantly reduce blood loss for up to five years before needing to be replaced.

For those who have no success with these treatments, Dr Walker said surgical options may be available.

These include an endometrial ablation, and a total laparoscopic hysterectomy (TLH) – a “last resort” which many women might put off until their late 40s or 50s due to fears about the procedure.

However, Dr Walker said they should seek help as soon as possible to avoid years of needless suffering.

"It's important for women to understand that today's hysterectomy has little resemblance to what it did 10 years ago when they were performed as an open surgery. A modern-day TLH is a minimally-invasive procedure involving three 5mm incisions in the abdomen which heal very quickly, with most women walking within hours of surgery and driving after a week,” Dr Walker said.

It is a misconception that ovaries are taken out during the operation, putting women into the "dreaded menopause". 

"This is definitely not the case as most hysterectomies only involve the removal of the uterus and cervix. In most cases, the ovaries are left behind so women don't go into 'premature menopause' – instead menopause usually happens several years later when nature takes it course,” Dr Walker said. 

He added that there are multiple benefits of this type of hysterectomy: no need to have Pap smears; risk of cervical and endometrial cancer is eliminated; and risk of ovarian cancer is reduced. 

For long-time sufferers of “menstrual misery”, he said it can also mean iron stores return to normal, energy is increased, debilitating period pain disappears, plus no more days off work or missed exercise.

"For those women who have finished having children and have failed with non-surgical methods, don't be afraid of hysterectomy. For eligible patients, and when done by a skilled surgeon, it can completely change your life for the better," Dr Walker said. 

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