Each year, approximately six hundred thousand women undergo surgery to remove the uterus — a hysterectomy. For many women with menstrual difficulties, hysterectomy seems like the best (or only) option. However, a study from UCLA found that nearly seventy percent of women could have been treated with non-surgical means — with equally positive results.
In some cases — uterine cancer, for example — a hysterectomy is the best option. In other cases, you may want to investigate non-surgical alternatives.
If you have heavy, painful periods but may want to become pregnant in the future, talk to your doctor about hormone therapy. Excessive bleeding is often triggered by hormone problems — especially for women in perimenopause. Hormonal birth control that includes progestin can help thin the lining of the uterus, resulting in a lighter period. Regular birth control (three weeks of active pills plus one week of placebos) may be enough to relieve the problem. If it doesn’t there are other forms of hormonal birth control that can manipulate how often you have a menstrual period. Talk to your doctor about birth control that gives you a period every three months or less. Ask about contraceptive injections and intrauterine devices, too. Hormone therapy doesn’t work immediately — expect to wait a few months for your periods to lighten.
If you have heavy, painful periods and do not want to become pregnant in the future, ask your doctor about endometrial ablation. This is an outpatient procedure that destroys the uterine lining. Approximately 85% of women who have this procedure report that it solves their menstrual problems for at least four years. At that point, about one third of women look into another treatment to control symptoms. Keep in mind that endometrial ablation doesn’t make pregnancy impossible — just risky. (You’ll have too little uterine lining to be able to support a baby.)
If you have fibroids that cause pain or bleeding and don’t intend to become pregnant in the future, ask your doctor about uterine fibroid embolization. In this procedure, a catheter is used to feed particles into your arteries. This blocks blood flow to the fibroids and causes them to die. Ninety percent of women who have this procedure find relief from pain for at least five years. At that point, about one fifth of patients find symptoms returning. You may need to seek a specialist for this procedure.
If you have fibroids that cause pain or bleeding and may want to become pregnant in the future, talk to your doctor about myomectomy. This surgery removes the fibroids while preserving fertility. Approximately 80% of women who have this surgery find relief from symptoms for at least two years. At that point, new fibroids may develop.
Talk to your doctor about all the options — don’t just jump into a hysterectomy (or any surgical procedure) without knowing the facts.