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July 17, 2019  
UTERINE NEWS: Feature Story

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  • Surgery and IUD Produce Similar Patient Results

    Surgery and IUD Produce Similar Patient Results for Heavy Periods

    August 16, 2006

    By: Jennifer Jope for Uterus1

    Although every woman’s menstrual cycle is different, there is an unlucky group of women who experience heavy menstrual bleeding, or menorrhagia, each month. But there is treatment available and a recent medical review found that a hormone-releasing intrauterine medication is as effective as surgery when it comes to satisfaction and improved quality of life.

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    Managing Menorrhagia

    While heavy menstrual bleeding isn’t manageable for all women, these are some steps to take to make it more bearable without surgery or drug therapy:
  • Work with your doctor by staying informed of your condition, including causes and new treatment options. Have your blood count and iron level measured at least once a year.
  • Consider taking iron supplements to avoid iron deficiency anemia.
  • Take care of your body with a healthy diet, enough rest and exercise and maintain stress levels.
  • Avoid aspirin because it may promote bleeding. Ibuprofen is effective in relieving menstrual pains.

    Find a doctor in your area who offers treatments for heavy bleeding.

  • Past research has shown that surgery is more effective than oral medication or an IUD when trying to reduce the volume of bleeding. But a review, which appeared in The Cochrane Library in May, shows that when measuring a woman’s satisfaction and improved quality of life, a hormone-releasing intrauterine device is equally effective as surgery.

    Although not mentioned in the study, another treatment method for heavy bleeding are non-surgical procedures that remove the uterine lining through forms of ablative therapy using microwave energy, heat, hot saline or electricity. The non-surgical procedures must be performed by a doctor, but do not involve long hospital stays or healing times.

    “Satisfaction with treatment is probably more meaningful than estimates of blood loss,” said Jane Marjoribanks, review co-author at the University of Auckland in New Zealand. “While conservative surgery reduced blood loss more than the IUD, the two treatments appeared about equal in terms of patient satisfaction.”

    The review found that compared to oral medication, such as birth control pills and nonsteroidal anti-inflammatory drugs, surgery to remove the lining of the uterus was “significantly” more effective in controlling bleeding and less likely to cause side effects.

    Meanwhile, the review also noted that a hysterectomy resulted in significantly greater improvements in mental health. The reviewers concluded that surgery, particularly hysterectomy, reduces bleeding at one year more than oral medication or an IUD. This is a definitive treatment because the surgery removes the uterus, therefore ending menstruation. The drawback to this option is that women interested in having children should not opt for this surgery. The reviewers also said that “adverse effects of hysterectomy were relatively common and potentially life-threatening” in the two trials that included this surgery. There were 39 complications among the 131 women who had a hysterectomy.

    However, researchers note that an IUD seems to be equally effective in improving quality of life. Evidence, they wrote, for longer term comparisons is “weak and inconsistent” and only a small population of women benefit from oral medication.

    While heavy bleeding is uncomfortable and inconvenient, it also can have other effects on a woman’s health. With more blood lost than necessary, a woman can become anemic. According to the Mayo Clinic, anemia occurs when there aren't enough healthy red blood cells to carry enough oxygen to body tissues. Often, the most common symptom is feelings of fatigue.

    Heavy menstrual bleeding can occur at any point in a woman’s reproductive life, but there are certain times when it can be more prevalent. The Mayo Clinic states that young women not ovulating regularly yet may be more susceptible to the heavy bleeding in the first year or 18 months after their first period. Conversely, older women approaching menopause may experience hormonal imbalances that could cause a heavier cycle of bleeding.

    But how do you determine if you have heavy menstrual bleeding? According to the Cochrane review, one in five women is affected by it. While the definition of heavy bleeding is somewhat subjective, there are few guidelines to go by. For example, some signs include a menstrual flow that soaks through one or more sanitary pads or tampons every hour for several consecutive hours, the need to use double sanitary protection to control menstrual flow, menstrual periods that last longer than a week and constant pain in your lower abdomen during your period.

    Related Content
    If you enjoyed this article, you might also be interested in the following:
    Heavy Bleeding 101 (Parts 1, 2 and 3)
    IUD Device Doubles as Treatment for Heavy Periods
    Women With Heavy Periods Express Concern About Symptoms, Treatment Options
    Less Invasive Treatment for Excessive Uterine Bleeding

    Last updated: 16-Aug-06


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