By the time they reach age 60, about 1/3 of American women would have had some form of pelvic disorder at some point in their lives. Of these women, over 20 million have elected to have their uterus removed through hysterectomy to relieve themselves of pelvic disorder symptoms.
If you are currently suffering from painful menstrual cramps with excessive bleeding or you were diagnosed with fibroids in your uterus or are suffering from endometriosis, you should know that there are now options to hysterectomy.
Uterine Fibroids
Uterine fibroids are tumors usually found on the smooth muscles of the uterus. Though most of the time found to be benign, these tumors cause pelvic pain and heavy menstrual bleeding. In worst cases, it could lead to infertility. The cause of uterine fibroids remains a mystery but they are known to be the major contributor to the big number of hysterectomies in any given year.
If you were diagnosed with uterine fibroids but don’t suffer from any uncomfortable symptoms, it would be wise to do “watchful waiting”. That is monitor your status with your doctor and do not opt for surgery right away.
However, if you are among those who experience unbearable pain, severe discomfort, or pressure symptoms, less-invasive options for treating fibroids are now available:
Myomectomy – is the removal of the fibroids alone through surgery. It can be done laparoscopically through the navel, through an abdominal operation, or via hysteroscopy which is inserting a thin, telescope-like instrument called a through the vagina.
The laparoscopic or hysteroscopic option is least invasive of the three, resulting in shorter recovery time. These two are also less costly than the abdominal operation.
Uterine Artery Embolization (UAE) – is also known as Uterine Fibroid Embolization (UFE). UAE or UFE is a fairly simple, non-invasive medical procedure wherein small particles are injected into the uterine arteries feeding the fibroids to cut off their blood supply.
This procedure has been used for years to help stop hemorrhage after surgery or childbirth.
Hysteroscopy – is a procedure involving insertion of a thin, telescope-like instrument called a hysteroscope through the patient’s vagina. Hysteroscopy is the preferred method of treatment if the fibroid is within the cavity of the uterus.
Hysteroscopy is a minor surgical procedure which translates to minimal recuperation time, but is only available to women whose fibroids are within the lining of the uterine cavity.
Medication - Pelvic discomfort or symptoms of uterine fibroids can initially be treated with Motrin, an anti-inflammatory, non-steroidal agent.
If Motrin is not effective in relieving pain and discomfort, one other option is a combination of drugs that blocks the production of estrogen and other hormones by the ovaries. However, use of this drug leads to symptoms of premature menopause and decrease in bone density.
Menorrhagia
Menorrhagia is severe vaginal bleeding which could be directly related to the presence of uterine fibroids. Though the medical threshold for menorrhagia is blood loss of more than 80 mL of blood in each menstrual cycle, most doctors nowadays define menorrhagia by how much it affects a woman’s daily life. If she is experiencing pain, prone to mood swings, and is being subjected to disruptions in her work, sexual activities, and other social activities, she is diagnosed to be suffering from menorrhagia.
Options for the treatment menorrhagia:
Medication – The first treatment of choice for menorrhagia is the use of oral contraceptives or through the insertion of an intrauterine device (IUD) that releases a hormone called Levonorgestrel.
These two treatments reduce menstrual bleeding significantly but women hoping to get pregnant in the future tend to prefer IUD.
Endometrial ablation – is a procedure to remove the lining of the uterus. However, patients should only consider this procedure if they are done with childbearing.
Uterine Prolapse
Uterine prolapse occurs when a woman’s uterus drops from its normal position and pushes against your vaginal walls. A number of causes can contribute to uterine prolapse but the most common are vaginal childbirth, obesity and getting old.
While a hysterectomy can quickly nip the condition in the bud there are now less drastic approaches that should also be considered. One such option is a vaginal pessary wherein a removable device is placed into the vagina to support specific areas where prolapse is happening.
Several different kinds of pessaries are available, depending on the gravity or extent of the prolapse. It would be best if you discuss with your doctor which one would be most appropriate for you. They
Bear in mind though that pessaries don’t cure the prolapse. They only offer relief from symptoms, partially or completely. If total cure from prolapse is what a woman desires, there are a host of surgical methods available for treating uterine prolapse. Surgeons often use one or a combination of techniques, so it is best to consult with them.
Endometriosis
Endometriosis occurs when the tissue called endometrium grows in other areas of the abdominal cavity, such as the ovaries, fallopian tubes, or outer surface of the uterus. Symptoms of endometriosis include pelvic pain, painful intercourse, spotting between periods, and infertility.
While around 18% of hysterectomies in the U.S. are performed due to endometriosis, it doesn’t really cure the problem. About 13% of women who underwent hysterectomy for endometriosis see their symptoms return within three years and the number reaches 40% in five years.
The alternative treatments for endometriosis depend on the severity of the symptoms and the woman’s needs. For the least severe type, over-the-counter pain relievers usually provide relief.
More severe cases that involve extreme pain and abnormal menstrual bleeding, hormonal treatments such as birth control pills may be prescribed to reduce estrogen levels.
If what is sought is a long-term treatment for endometriosis, laparoscopic surgery may be resorted to. Surgeons can also take a more invasive approach, a laparotomy, which involves making a larger cut in the abdomen.
Chronic Pelvic Pain
Chronic pelvic pain can be caused by many things, including uterine fibroids, endometriosis, pelvic inflammatory disease, and bowel or bladder problems.
Treatment options depend on the cause of the pain, but typically includes stopping ovulation with hormonal or birth control pills, abdominal trigger point injections, antibiotics, and even relaxation exercises.
The bottom line is whatever your health condition might be, a hysterectomy is not the only option. New alternatives are being made available, so it is important to discuss your options with your doctor before making any decisions.
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