TREATMENT FOR MENORRHAGIA

Specific treatment for menorrhagia is based on a number offactors, including :

• Your overall health and medical history
• The cause and severity of the condition
• Your tolerance for specific medications, procedures ortherapies
• The likelihood that your periods will become less heavybefore long
• Your future childbearing plans
• Effects of the condition on your lifestyle
• Your opinion or personal preference

Treatment options include pharmaceutical or surgical andradiological option :

A. Pharmaceutical treatments

1. First line
The hormonal IUD (Mirena)
This type of intrauterine device releases a type of progestin calledlevonorgestrel, which makes the uterine lining thin and decreases menstrualblood flow and cramping.

2. Second Line

Iron supplements.
If the condition is accompanied by anemia, your doctor may recommend that youtake iron supplements regularly. If your iron levels are low but you're not yetanemic, you may be started on iron supplements rather than waiting until youbecome anemic.

Tranexamic acid an antifibrinolytic agent
Non steroidal anti inflammatory drugs (NSAIDs).
NSAIDs, such as ibuprofen (Advil, Motrin, others), help reduce menstrual bloodloss. NSAIDs have the added benefit of relieving painful menstrual cramps (dysmenorrhea).

Combined oral contraceptive pills to prevent proliferation of the endometrial.
Aside from providing effective birth control, oral contraceptives can helpregulate menstrual cycles and reduce episodes of excessive or prolongedmenstrual bleeding.

3. Third line

Oral progestogen
e.g. norethisterone, to prevent proliferation of the endometrial. When takenfor 10 or more days of each menstrual cycle, the hormone progesterone can helpcorrect hormonal imbalance and

reduce menorrhagia.

Injected progestogen (e.g. depo provera)

Gonadotrophin-releasing hormone (GnRH) agonists (e.g.goserelin)

B. Surgical and radiological treatments

1. Dilation and curettage ( D & C )
D&C is no longer performed for cases of simple menorrhagia, having areserved role if a spontaneous abortion is incomplete. In this procedure, yourdoctor opens (dilates) your cervix and then scrapes or suctions tissue from thelining of your uterus to reduce menstrual bleeding. Although this procedure iscommon and often treats menorrhagia successfully, you may need additional D andC procedures if menorrhagia recurs.

2. Endometrial ablation.
Using a variety of techniques, your doctor permanently destroys the entirelining of your uterus (endometrium). After endometrial ablation, most womenhave little or no menstrual flow. Endometrial ablation reduces your ability tobecome pregnant.

3. Uterine artery embolisation (UAE)

4. Operative hysteroscopy.
This procedure uses a tiny tube with a light (hysteroscope) to view youruterine cavity and can aid in the surgical removal of a polyp that may becausing excessive menstrual bleeding. Hysteroscopy myomectomy to removefibroids over 3 cm in diameter.

5. Hysterectomy.
Surgical removal of the uterus and cervix is a permanent procedure that causessterility and cessation of menstrual periods. Hysterectomy is performed underanesthesia and requires hospitalization. Additional removal of the ovaries(bilateral oophorectomy) may cause premature menopause in younger women.

6. Endometrial resection.
This surgical procedure uses an electrosurgical wire loop to remove the liningof the uterus. Both endometrial ablation and endometrial resection benefitwomen who have very heavy menstrual bleeding. Like endometrial ablation, thisprocedure reduces your ability to become pregnant.

Posted in: health,menorrhagia