With this article, it is with great pleasure that I introduce to you my beginning series of editorials to discuss minimally invasive approaches to women’s health. We will begin by addressing a condition that I see affecting many women tremendously: abnormal vaginal bleeding. It creates anemia, associated fatigue, and if left unattended, can be life threatening.
What are the main objectives of treatment? Safety and quality of life. If pregnancy is present, urgent attention is needed. For young ladies, the possibility of experiencing a blood clotting disorder, presence of ovarian cysts, or potential hormonal disbalance (along with other concerns) must be taken into consideration. Further in reproductive years, such bleeding can signal uterine fibroids, adenomyosis (glands of the uterus within the muscle of the uterus), uterine polyps, cervical or vaginal problems and overgrowth of the lining of the uterus that can lead to malignancy.
For some, you may not realize the heaviness of your bleeding, so we always check your hemoglobin at the time of annual visits. Initial evaluation for vaginal bleeding (in addition to history and examination) includes a pain free Transvaginal (TV) ultrasound that can be performed during a first visit. This ultrasound results in an abundance of information on the structure of your uterus, the endometrial lining and cervix, and confirms the normal architecture of the ovaries.
From here, it is determined whether or not a biopsy needs to be performed, noninvasive approaches are applicable or minimally invasive procedures or outpatient surgeries must be performed. There are many options in medicine to help you, and they each start with listening to what is happening in your life now, and what course can be taken to move you back to the joys of life easily, freely and fully.
Be brave and believe that everything will be OK.
With much love,
Assia Stepanian