Gynecology patients have new options
Dr. Steven Gelber
» Initial considerations in treating menstrual problems
The first step in treatment is to evaluate the nature of the menstrual problem to determine if it is a medical issue or related to lifestyle. If it is medical, the next step is to establish the cause and determine how serious the problem is and whether it should be treated medically or surgically.
If the problem is heavy flow, sometimes the solution can be as simple as taking an anti-inflammatory medication, such as ibuprofen, in doses of 600 to 800 milligrams three times a day for a couple of days prior to and during the first two days of a period. While most people think anti-inflammatory medications are for pain only, they also diminish the flow of blood significantly for most women.
» Common problems and approaches to treatment
If you are experiencing problems with heavy blood flow, your doctor might recommend hormone treatment, either progesterone or the birth control pill. If you suffer from irregular periods, your doctor may suggest a full hormone workup to determine the cause.
If the root of the problem is structural, such as the presence of uterine fibroids or polyps, you may need an ultrasound to assess the situation.
» When you're not a candidate for medical or hormone treatment
If you suffer from heavy or abnormal menstrual bleeding and previous approaches to treatment have not worked to alleviate the problem, your doctor may suggest a procedure called endometrial ablation. This procedure utilizes either a cautery or heated water to render the uterine lining unresponsive to hormones. This way the uterine lining does not regenerate although the uterine muscles remain intact.
» New minimally invasive hysterectomy
Hysterectomy is another mainstay treatment of excessive uterine bleeding. Gynecologists at Cayuga Medical Center often perform hysterectomies using a laparoscope to remove the uterus through the vagina, making it much less likely to require a large surgical incision in the abdomen. The recovery time is faster because the surgery is performed through three or four tiny incisions and patients can return to their normal activities more quickly.
Hysterectomies have also become much more individualized to each woman's situation. Several different options are available to patients now, including hysterectomy in which the uterus and ovaries are completely removed; removal of the uterus and cervix; and removal of the uterus only, while leaving the cervix in place.
Our goal is to solve excessive menstrual problems without doing more than needs to be done. This is best accomplished when women and their doctors have an informed discussion about what the treatment options are and what is most important to the patient.
Gelber is board certified in obstetrics and gynecology and is a member of the medical staff of Cayuga Medical Center. He is in practice with Ob-Gyn Associates of Ithaca, where he can be reached at (607) 266-7800.