Other Options for Heavy Bleeding
Heavy uterine bleeding is defined as bleeding that's so heavy that you have to change your work or leisure schedule to accommodate your periods. This heavy bleeding can be caused by hormonal imbalances where the lining of the uterus grows thicker and thicker due to the effect of unopposed estrogen. In these situations the ovary produces estrogen without the normal counterbalance of progesterone. Other causes for heavy bleeding can include structural problems like uterine fibroids and uterine polyps. More rarely, cancerous or precancerous changes of the lining of the uterus can cause heavy bleeding. Rarer still are conditions where blood doesn't clot normally due to inherited defects like von Willebrand's syndrome.
Alternatives for treating bleeding problems fall into two major categories: Hormonal and Surgical.
Hormonal Options
- Oral contraceptives (birth control pills) are used for their side effects of lighter, less crampy periods that occur at predictable times. Obviously, the pill is not for everyone-for example, smokers who are over 35, women who have chronic hypertension or who have a history of blood clots in their legs or lungs. The advantage of the pill is its effectiveness, ease of use, and reversibility.
- Nuvaring is a vaginal contraceptive ring that acts like birth control pills.
- Depo Provera ("Depo") is a quarterly contraceptive shot that can also be used to thin the lining of the uterus.
- Progestins (natural or synthetic) can be used daily or for several days per month to thin the lining of the uterus or trigger regular periods.
Surgical Options
- D&C-an office or hospital procedure where the cervix is opened ("dilated"=D) and the uterine lining is scraped ("curetted"=C) to thin the overgrown glandular lining that is causing heavy bleeding.
- Hysteroscopy with myomectomy or polypectomy-an office or hospital procedure where a lighted is placed through the cervical canal and the uterine cavity is visualized. Uterine fibroids or polyps can be removed through the cervix.
- Hysterectomy-removes the uterus to permanently stop bleeding.
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