Heavy Periods
Heavy bleeding can be very frustrating. Women worry about embarrassing staining in public. One has to think twice about wearing light-coloured clothes during periods. The pain and cramping in lower abdomen is very annoying. And sometimes this bleeding drags on longer than a week or more. One is in dilemma how to deal with it.

What causes heavy periods?
Ladies can get heavy bleeding for a number of reasons. Sometimes it can be from polyps or fibroids in the uterus, which are non – cancerous growths. Or there may be trouble with the lining of the uterus or from new tissue growth. It can even be due to the way blood clots or because of a medicine that ladies may be taking.

For many women it happens because their hormones are out of balance. Hormones control the thickening of the endometrium. This is the tissue that lines the inside of the uterus. The endometrium is shed each month during the periods. If women have a hormone imbalance, it may make the endometrial lining THICKER than usual and this causes heavier bleeding (clots or prolonged bleeding).

What can women do about it?
Women can treat heavy periods due to a hormonal imbalance in various ways if they are young, at first, gynaecologists may give hormone therapy such as a contraceptive pill. If this doesn’t work, there are other options.

A short term solution is a D & C (dilation and curettage). Women can have this done as an outpatient procedure. The consultant scrapes tissue away from the lining of the uterus by the thin cannula. This is not uncomfortable. It is done as an office procedure all over the world. D & C usually eases the problem for one or two cycles only.

The traditionally long term solution is a HYSTERECTOMY. This is a major surgery to remove the whole womb and should not be taken lightly. It means being in hospital for some days and women may end up with an ugly scar. It takes almost 3 months to heal completely.  Women have no chance of becoming pregnant. If ovaries are removed as well, the menopause starts at once and women may need to go onto hormone treatment for life.

Is there an alternative?
Yes. Now, there is simple procedure almost like D & C procedure, which usually solves the problem once and for all. It’s called Thermachoice (Uterine Balloon Therapy) and it uses a technique known as global endometrial ablation. Besides Uterine Balloon Therapy, there are few more techniques of global endometrial ablation.

What is Thermachioce uterine endometrial ablation?
This uses a tiny heated balloon to remove the endometrial lining of the uterus. This involves no surgical cut. It’s a done as out outpatient treatment in USA, China and Korea. Surgery takes about half an hour. Afterwards, 98% of women find their periods return to normal, or they become much lighter or stop completely. Nearly 3 out of 4 women also find it reduces menstrual pain and cramping. The best thing is that women need not remove their uterus and at the some time do not need hormone therapy.

How does it work?
The doctor uses a very small, soft, flexible balloon at the end of a thin tube. The balloon is made of silicon to avoid any allergic reaction. The tube and deflated balloon are eased through the vagina and cervix, and then placed gently into the uterus. The consultant then fills the balloon with fluid so that it inflates to the size and shape of the uterus. The fluid is gently heated and circulates around the uterus for eight minutes. This destroys the lining. The doctor removes the fluid from the balloon, which then deflates, and carefully pulls it out. Nothing remains in the uterus apart from the treated uterus lining and this simply falls away. The machine is fully computerized and US – FDA approved.

Does it hurt?
Not really. During the treatment she is given short anaesthesia. For a little time afterwards women may feel slight discomfort. Maximum woman may get cramps like in a period on the first day. Gynaecologist will usually give a painkiller like ibuprofen and sometimes a mild sedative to help women to relax. If women prefers, this treatment can be done under local anaesthetia. After discharge the women can take some more painkillers if there is any need for it.

What happens next?
It is a wonderful simple procedure. After a night sleep, i.e. by the next day one is able to get back to normal routine. One should avoid sex for 3-4 weeks. It’s normal to have a pinkish, watery vaginal discharge for few days. If one starts getting severe pain, high fever or abdominal bloating, one should contact the doctor at once. Normally no such symptoms are usually noted.

What about fertility and contraception?
One should not have this treatment if one wants to become pregnant. This procedure makes pregnancy unlikely but a small chance still remains and pregnancies are reported. This is why after this treatment, it is vital to use  effective birth control. Injection of long acting progesterone every three months is usually recommended by few experts.
Infact according to Dr. Sharda Jain, President of Delhi Gynaecologist Forum, and Dr. Kamal Buckshee former HOD AIIMS Delhi, these injections of Depot progesterone taken at 3 months intervals helps in improving the effect of Uterine Balloon Therapy tremendously.

Is it safe?
Yes. Problems as a result of uterine balloon therapy treatment are extremely rare.

Does it work?
Yes. More than 600,000 people around the world have been treated with Thermachoice techniques. Clinical studies over 5 years have shown it to be a reliable and very effective treatment in 96% of women. In fact, consultants world over recommend it three times more often than other endometrial ablation techniques. With proper selection of cases, (i.e. excluding cases of fibroid uterus and uterine cancer) the results show 98-99% success specially if 4 shots of injection Depot progesterone are taken at 3 monthly interval.

What should you do next?
You have to create public awareness about this simple procedure.

If you and your friends suffer from heavy bleeding, they should talk to their gynaecologist about it. This is relatively new technique launched all over the world in last 7 years only. You may find it useful to take this paper cutting with you. This is not cheap but very patient friendly procedure. It is covered under Mediclaim (Health insurance schemes) and this facility is available in major hospitals in the country.