Upload
patrick-poole
View
241
Download
4
Embed Size (px)
Citation preview
ABNORMAL UTERINE BLEEDING
Dr Rooma Sinha, MD, DNBSenior Consultant Gynecologist & Laparoscopic Surgeon
Apollo Health City; HYDERABADwww.gynecologyhyderabad.com,
[email protected] 9550326662; 9849008180
Women have menstrual cycles from the age of 11-12 years to about 50 years. In this time span of 40 years one is likely to have few episodes of bleeding which is not her usual cycle.
Abnormal uterine bleeding can be as follows-One must be concerned and consult gynecologist
• Bleeding between periods • Bleeding after sex • Spotting anytime in the menstrual cycle • Bleeding heavier or longer than normal - Passage of clots• Absence of menstrual periods for 3 normal cycles or 6 month• Severe pain associated with periods
Why Worry?
• Excessive bleeding can lead to anaemia, weakness
• Pain can affect daily activities
• Can be initial indication of a serious disorder
www.gynecologyhyderabad.com
Abnormalities that cause abnormal bleeding
• Fibroid uterus/Adenomyosis• Pelvic inflammatory disease• Cancer of uterus • Dysfunctional Uterine Bleeding• Endometriosis• PCOS• Pregnancy complications
www.gynecologyhyderabad.com
How We Evaluate Abnormal Bleeding?• Pelvic USG
• Dilatation & curettage
• Hysteroscopy & directed Endometrial biopsy
• Thyroid profile
www.gynecologyhyderabad.com
Maintain a menstrual calendar - it gives a good insight into the problem if the bleeding pattern is
available over 4-6 months for the doctor to evaluate
Ask Questions from your doctor• Medical intervention?• Surgical intervention?• Era of minimally invasive surgery!! • Look carefully for reasons for not
going for key hole surgeries• All Gynecological surgeries can be
done with key hole
www.gynecologyhyderabad.com
Medical treatment
DEPENDS ON -cause, age, severity ; desire for future pregnancies
•Antifibrinolytic medication to reduce the blood loss during periods •HORMONES-– Progesterone alone (for endometrial hyperplasia)– Combined pills – MIRENA- intrauterine device with impregnated
hormone
Surgical method
• Removal of fibroid- Laparoscopy /Robotic / Hysteroscopy
• Hysterectomy—removal of the uterus—is another procedure that may be used to treat abnormal bleeding
• Thermal balloon ablation is a method to treat dysfunctional bleeding without removing the fibroid
Advantage of minimally invasive surgery- LAPAROSCOPY/ROBOTIC
• No Scar- beautiful body
• No pain
• Quick return to normal activity
• Less postoperative problems- as less tissue handling so less damage!!
• NO HERNIAS
www.gynecologyhyderabad.com
Finally...
• If you notice that your cycles have become irregular, it is better to consult a gynecologist. Abnormal bleeding has a number of causes.
• There is no way of telling why your bleeding is abnormal until a gynecologist has made an assessment of your problems.
• Once the cause is found, abnormal bleeding often can be treated with success.