Depending on cause and severity of symptoms of Menorrhagia, the condition may be managed with medications or by Surgical approach. If your menorrhagia is due to some medications (e.g. hormones), it may be possible to manage it by simply withdrawing or stopping the medications. If medical management of menorrhagia fails, surgical approach may be tried. Surgical management of menorrhagia include use of following procedures,
- D&C (Dilatation and Curettage): this procedure involves dilatation of cervix and scraping (or suction) of tissues from lining of uterus, which help reduce bleeding during menstruation. This procedure is commonly used and it is successful in most acute cases of menorrhagia. However, if condition recurs the procedure may have to be repeated.
- Myomectomy: this is surgical removal of uterine fibroid, which is one of the common causes of menorrhagia. Myomectomy can be done by opening abdomen, laparoscopically or by vaginal and cervical approach (hysteroscopically), depending on the number of fibroids, size and location of the fibroids.
- Uterine artery embolization: this is done to block uterine arteries that supply the fibroids and uterus and thereby shrinking the fibroid. This is also done if menorrhagia is due to fibroids.
- Focused ultrasound ablation: this procedure is used to shrink uterine fibroids. This procedure involved use of focused ultrasound waves to destroy fibroid and shrink it to prevent excess menstrual bleeding.
- Endometrial ablation: in this surgical procedure the surgeon destroys the endometrial lining of uterus permanently. After this procedure most patients report lighter bleeding during menstruation. However, this procedure should be done only after completing family with desired number of children. Because, pregnancy after endometrial ablation can put you in risk. After this procedure, a permanent contraceptive procedure (such as tubectomy, vasectomy, etc.) should be done, to prevent pregnancy.
- Endometrial resection: this procedure involve removal endometrial lining of uterus using electrosurgical wire loop. This is useful for women with excessive heavy menstrual bleeding. Pregnancy is not recommended after this procedure.
- Hysterectomy: in all the above mentioned surgical procedures uterus is preserved and recommended for women who would like to keep their uterus. Those women, who have completed their family and in middle age group, may remove uterus (hysterectomy) and get rid of menstrual cycle and bleeding permanently. This procedure can also be used for patients who do not benefit from medical management as well as conservative surgical approaches mentioned above.
All the above mentioned surgical procedures are generally done as outpatient procedure, except hysterectomy.
Image courtesy of [David Castillo Dominici] at FreeDigitalPhotos.net