When a women experiences heavy or irregular periods, it is referred to as menorrhagia in medical nomenclature.
There are vast reasons for the problem and treatment varies according to the reasons, but as a rule the treatment is either hormonal or surgical.
Hormonal treatment includes single hormone, combinations of hormones like the contraceptive pill or the intrauterine device, called a Mirena.
Surgical treatment may be ablation or removal of growths or hysterectomy.
Ablation is a medical term that means “destruction”. During
During ablation of the uterus the endometrial tissue is destroyed using radiofrequency waves. It is not a guarantee that all bleeding will be stopped but in 80% of cases the results are excellent, with the advantage that surgery is not done and the patients are discharged the same day and they can go back to work within days.
In some patients heavy periods are caused by growths inside the cavity of the uterus, mostly polyps or fibroids. These can be removed using a hysteroscopy where by a camera is inserted into the uterine cavity; the growths are identified and then removed. The hysteroscope is also handy to diagnose adhesions inside the endometrial cavity and to diagnose possible cancer of the uterus.
In the event of growths like fibroids causing the menorrhagia they can be removed with a myomectomy, which is performed either through a laparoscope or through a laparotomy (when they are too large to be removed through a laparoscope).
Hysterectomy means removal of the uterus and mostly the cervix. This can be done abdominally or vaginally. A vaginal hysterectomy is mostly less painful and the recovery is much faster than an abdominal hysterectomy. Sometimes the ovaries will also be removed if they carry disease or if the patient is older than 50 years.
All gynaecological operations are done in close proximity of big blood vessel, large bowel, small bowel, bladder and ureters. Injury to these may occur, but luckily very infrequently. We live in a world where germs are not visible but everywhere. Infections are thus complications of any surgery but we follow modern techniques to minimise this scourge. These include sterile theatre working environment, intra operative antibiotics, suturing material impregnated with anti-bacterial agents etc.