Heavy or prolonged menstrual bleeding can be tackled through minimally invasive procedures including Mirena inter-uterine device and endometrial ablation or resection.
When menorrhagia or abnormal bleeding stems from anatomical problems like fibroids and polyps, the recourse, two decades ago, used to be an invasive surgical procedure called myomectomy or removal of the noncancerous growths.
But myomectomy did not always stop the bleeding. And there are other causes behind abnormal bleeding, like hormonal imbalances.
For a majority of patients, the outlook was pretty unpleasant. High-dose hormones caused a host of side effects like rapid weight gain. A procedure called dilation and curettage, or D&C, which scraped away the lining of the uterus, typically failed to stop the bleeding for more than a few months.
The last resort was a hysterectomy major surgery to remove the uterus and sometimes other reproductive organs as well.
But things have since changed a lot. Women no longer need to choose between suffering and major surgery, said Dr. Glenn Schattman, a reproductive surgeon and associate professor of obstetrics and gynecology at the New York Presbyterian Hospital/Weill Medical College of Cornell. Today, the key is avoiding major surgery, and thankfully, the overwhelming majority of patients can now be treated with minimally invasive procedures or medication.
The changes began in 1987, when the Food and Drug Administration approved a laser that could destroy the lining of the uterus by heating it. The laser outpatient procedure that became known as endometrial ablation was a retreat from the finality of a hysterectomy which, back then also required up to two months of recovery time, Carolyn Sayre writes in New York Times.