Having to constantly change a towel or tampon, or even having to wear it to avoid clothing disaster. Suffering from abdominal pain. And you feel tired because the bleeding is important. For women who have very heavy periods, or menorrhagia, seeing the English land can turn into a nightmare every month.
However, suffering and Niagara Falls in panties is not inevitable. Therapeutic solutions are available to allow them to regain comfort and serenity. Among them, minimally invasive surgeries can be offered to some.
Assess its flow and make a diagnosis
When is the menstrual cycle heavy? “Usually, women know if they are losing too much or too much blood,” notes Professor Hervé Fernández, Head of the Department of Obstetrics and Gynecology at CHU Bicêtre and former President of the Society for Gynecological and Pelvic Surgery. A tool, the degree of higham, makes it possible to personify this profuse bleeding. ” Among these: the number of periodic means of protection used every day of menstruation and the level of their saturation are all indicators. “Then, we must find the cause of this menorrhagia.” Extreme fatigue and anemia Severe anxiety is also a common repercussion of a heavy menstrual cycle, which affects one in five women on average.
Clinical examination, ultrasound or even hysteroscopy [exploration de l’utérus avec une petite caméra] It made it possible to make a diagnosis, points out Dr. Vincent Velfranke, chief of the department of gynecology at Simone-Veil Hospital in Eaubonne. The causes can be organic: polyp, fibroid, or adenomyosis [une forme particulière d’endométriose qui touche l’utérus] ; functional, for example in the case of PCOS (PCOS); Or even hormones. And this is a major topic: Abnormal bleeding is the main reason for consultation for women aged 40 to 50. Hence the importance of an accurate diagnosis.”
Minimally invasive surgery for fast treatment
Once the diagnosis is made, “depending on the pathology and pregnancy plans or not, medical or surgical treatment will be offered,” Professor Fernandez adds. But it has been suggested in light of a new paradigm: the concept of young women of childbearing age is changing, and patients as young as 45 may wish to , or up to 48, in pregnancy.In this case, the proposed therapeutic elements will have to be adapted, and will not necessarily be eligible for some minimally invasive surgery.Warning that a woman who wishes to preserve her fertility will be able to benefit from this care in the event of a tumor , for example, but not when she has menorrhagia because the uterine lining is so dense that the lining of the womb must be destroyed.
For women who qualify for surgery, it is not always easy to consider an intervention. “When surgery is prescribed, the classic course provides an operating room intervention, under sedation, followed by downtime, which can be a bit frightening, Dr. Vilfranki points out. That is why it has become necessary to develop a course for patients, he insists, to be able To offer minimally invasive surgeries by means of rapid in-clinic treatment, for lesions such as polyps or fibroids.This is how the Consultation and Exploration Units emerged, where surgical hysteroscopy can be performed outside the premises.This allows, in a single procedure, a rapid diagnosis And offering the lowest possible treatment, to go in for just a few minutes, without a scalpel or general anaesthesia, but with local anaesthesia. This care puts a lot of pressure on patients who recover faster. And with a very high satisfaction rate.” A favorable development is a nomenclature change accompanied by incentivized pricing, and “the context of delays in care at the height of the COVID-19 pandemic and the shortage of caregivers, highlighting the need to identify effective approaches outside operating rooms,” explains Dr.
These minimally invasive surgeries thrive outside the building. It can also sometimes be indicated for patients with functional metrorrhagia, profuse bleeding that can occur outside of menstruation or after menopause, which can be organic or related to a hormonal imbalance. Previously, the first line of treatment was the insertion of an intrauterine device, the hormonal IUD, Dr. Vilfranchi reports. But if this treatment in general works well, and in detail, a quarter of patients will not tolerate it and will bleed every day for the first three months, which may legitimately discourage some.” But “today, many women are turning away from hormonal treatments, as Professor Fernandez confirms. And when we have techniques that allow us to intervene in the office in 1.30 minutes, this raises the question of which treatment is most appropriate to recommend in the first intent.”
To date, approximately 90,000 hysteroscopies are performed each year in France. And “By emphasizing that practitioners’ training in this gesture is no more complicated than inserting an IUD, Dr. Vilfranki recalls, in the long run, most of them can be carried out outside operating rooms.”
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