By Christopher A. Naraine
Irregular menstrual periods can turn a woman’s life upside down.
In fact, abnormal bleeding is one of the most common reasons women of all ages seek gynecological care.
Fortunately, the condition is often treatable whether with hormone therapy or minimally invasive surgical procedures and women can get on with their normal lives.
For women who require surgery to treat abnormal uterine bleeding, University Medical Center at Princeton offers the da Vinci Surgical System, a safe and effective alternative to traditional open surgery.
About abnormal bleeding
Typically, a woman’s menstrual cycle lasts about 28 days, counted from the first day of one period to the first day of the next. The duration of a period varies from woman to woman, but is generally about seven days.
The cycle is normally predictable and is controlled by an intricate physiological system that triggers the ovaries to release hormones each month. These hormones cause the endometrium the lining of the uterus – to grow in preparation for a possible pregnancy. If pregnancy does not happen, the uterus sheds the lining and a period occurs.
Yet for many women this process gets disrupted, causing abnormal bleeding. The American College of Obstetricians and Gynecologists defines abnormal bleeding as:
* Bleeding between periods
* Bleeding after intercourse
* Spotting anytime during the menstrual cycle
* Bleeding heavier or for more days than normal
* Bleeding after menopause
Moreover, menstrual cycles that last longer than 35 days or less than 21 days are abnormal.
Causes of abnormal bleeding
There are a range of causes for abnormal bleeding and some are more serious than others, making it all the more important to see your doctor for a correct diagnosis. In addition to hormone imbalances, two of the most common reasons for abnormal bleeding are polycystic ovarian syndrome and uterine fibroids.
Polycystic ovarian syndrome is an endocrine disorder characterized by several tiny cysts ringing the ovary. An estimated one in 10 women of childbearing age suffer from polycystic ovarian syndrome, according to federal health statistics.
Uterine fibroids are benign (non-cancerous) tumors that develop in the uterus. Up to 80 percent of women develop fibroids by the time they reach age 50, according to the U.S. Department of Health and Human Services.
In rare instances, abnormal uterine bleeding may be a sign of uterine cancer.
Diagnosis and treatment
Diagnosing abnormal uterine bleeding is fairly straightforward and involves a medical history and pelvic exam and often a transvaginal ultrasound and/or hysteroscopy a visual inspection of the uterus using a lighted viewing instrument called a hysteroscope.
Treatment depends on the cause of the bleeding as well as a woman’s age and future childbearing plans, but in most cases hormone medications are enough to control the condition. Doctors may also recommend endometrial ablation, which uses electricity, laser, heat or freezing to destroy the lining of the uterus.
If cysts or fibroids cause bleeding, surgery may be the best form of treatment. For years, traditional open gynecologic surgery, using a large incision for access to the uterus and surrounding anatomy, has been the standard approach to many gynecological procedures.
Today, however, women have another option with the da Vinci Surgical System. The da Vinci System is enabling specially trained doctors at University Medical Center at Princeton to perform complex gynecological surgeries including myomectomy, cystectomy and hysterectomy through tiny 1 to 2 centimeter incisions.
Surgeons using the robotic-assisted da Vinci System can operate with greater precision and control, minimizing the pain and risk associated with large incisions while increasing the likelihood of a fast recovery and excellent clinical outcomes.
The potential benefits of surgery with da Vinci include:
* Less pain
* Less scarring
* Less blood loss
* Shorter recovery time
Not all women are candidates for da Vinci, but if your doctor recommends gynecological surgery, talk with him or her about your options and how to minimize the period of pain, discomfort and extended time away from normal daily activities that usually follows traditional surgery.
If abnormal uterine bleeding is turning your life upside down, talk to your doctor. With the proper diagnosis and the appropriate treatment approach, you can get back to the normal cycle of life.
For more information about the da Vinci Surgical System at University Medical Center at Princeton or to find a University Medical Center at Princeton da Vinci surgeon, call (888) 742-7496.
Princeton HealthCare System through its Community Education & Outreach Program will host a discussion titled Abnormal Uterine Bleeding: Causes and Treatments from 6:30 to 8:30 p.m. on Monday, Oct. 24, at the Hamilton Area YMCA John K. Rafferty Branch, 1315 Whitehorse-Mercerville Road, Suite 100, Hamilton.
To register for the free session or for more information, visit www.princetonhcs.org/calendar or call (888) 897-8979.
Christopher A. Naraine, M.D., F.A.C.O.G. is board certified in obstetrics and gynecology and is a fellow of the American College of Obstetricians and Gynecologists. He is a member of the medical staff at University Medical Center at Princeton.
