Women's Health

Excessive Menstrual Bleeding

If your periods are so heavy that they disrupt your normal daily activities, you may have excessive menstrual bleeding. The medical term for periods that are very heavy, prolonged, or both is menorrhagia. Symptoms of menorrhagia may also include cramping, pelvic pain and, in severe cases, anemia.

Excessive menstrual bleeding is a common condition that occurs for many of reasons. Two of the most common causes are: a hormonal imbalance and uterine growths.

Hormonal Imbalances

Your menstrual cycle is controlled by hormones, including estrogen and progesterone. When these hormones are out of balance, they can cause heavy periods or bleeding between periods. Causes of hormonal imbalances may include:

Hormonal changes in teens and in women nearing menopause
Diabetes
Thyroid disease
Obesity
Stress
Strenuous exercise
Anorexia (eating disorder)

Types of Uterine Growths

Fibroids - benign (non-cancerous) growths in or near the uterus
Polyps - growths that attach to the inner wall of the uterus and protrude into the uterine cavity
Adenomyosis - endometrial tissue normally lining the uterus grows into the muscular walls of the uterus
Endometriosis - tissue that normally lines the inside of your uterus grows outside your uterus
Endometrial cancer - an uncontrolled growth of cells of the uterine lining
Hyperplasia - an abnormal proliferation of cells (cell division or growth) that may result in enlargement (growth) of the uterus. This term is sometimes used to refer to a benign tumor or fibroid.

Treatment Options for Excessive Menstrual Bleeding

Excessive menstrual bleeding can be treated with hormone therapy, surgery or a combination of both. Your doctor can diagnose your condition and provide treatment(s) to relieve your symptoms.

Hormone Therapy

Your doctor may recommend you take hormones such as progesterone or the birth control pill to control and regulate your period. Hormone therapy can limit the swelling of your endometrium (uterine lining that sheds each month during your period) and extra endometrial tissue (implants). This treatment may be used before, instead of, or after surgery.

Surgery

Surgical procedures to treat excessive bleeding include endometrial ablation, endometrial resection and hysterectomy.

Endometrial ablation. Energy is used to destroy the endometrial lining of the uterus with the goal of lightening or stopping your periods. This technique is usually done on an out-patient basis and is generally not recommended for women who may want to get pregnant.
Endometrial resection. The surgical removal of the uterine lining.
Hysterectomy. The surgical removal of your uterus. Depending upon your condition, your fallopian tubes, ovaries and any visible growths may also be removed. .

A hysterectomy can be performed using traditional open or laparoscopic surgery. Open surgery involves a large abdominal incision (laparotomy), significant trauma to the body and a lengthy recovery. Traditional laparoscopic surgery is minimally invasive – surgeons operate through a few small incisions. Laparoscopic surgery requires the use of long-handled, rigid instruments, which can present challenges during complex or delicate operations that require a greater degree of precision or dexterity.

da Vinci® Surgery

Fortunately, there is a minimally invasive option for treating gynecologic conditions designed to overcome the limits of traditional open and laparoscopic surgery – da Vinci Surgery.

If your doctor recommends surgery to treat excessive menstrual bleeding, you may be a candidate for da Vinci Surgery. Using state-of-the-art technology, da Vinci® Surgery requires only a few tiny incisions so you can get back to your life faster.

The da Vinci System enables your doctor to perform surgery for complex conditions with enhanced vision, precision, dexterity and control. da Vinci Hysterectomy offers women many potential benefits over traditional surgery, including:

Less pain¹
Fewer complications²
Less blood loss^3,4
Shorter hospital stay⁴
Low risk of wound infection⁵
Quicker recovery and return to normal activities⁶

The da Vinci System\ is a state-of-the-art surgical platform with 3D, high-definition vision and miniaturized, wristed surgical instruments designed to help doctors take surgery beyond the limits of the human hand. By helping doctors to overcome the challenges of traditional open and laparoscopic surgery, da Vinci is changing the experience of surgery for women around the world.

If you have been putting off treatment for a gynecologic condition, it's time to ask your doctor about da Vinci Surgery.

As with any surgery, these benefits cannot be guaranteed since surgery is specific to each patient, condition and procedure. It is important to talk to your doctor about all treatment options, including the risks and benefits. This information can help you to make the best decision for your situation.

While clinical studies support the effectiveness of the da Vinci Surgical System when used in minimally invasive surgery, individual results may vary. There are no guarantees of outcome. All surgeries involve the risk of major complications. Before you decide on surgery, discuss treatment options with your doctor. Understanding the risks of each treatment can help you make the best decision for your individual situation. Surgery with the da Vinci Surgical System may not be appropriate for every individual; it may not be applicable to your condition. Always ask your doctor about all treatment options, as well as their risks and benefits. Only your doctor can determine whether da Vinci Surgery is appropriate for your situation. The clinical information and opinions, including any inaccuracies expressed in this material by patients or doctors about da Vinci Surgery, are not necessarily those of Intuitive Surgical, Inc. and should not be considered as substitute for medical advice provided by your doctor. © 2011 Intuitive Surgical. All rights reserved.

Ko EM, Muto MG, Berkowitz RS, Feltmate CM.Robotic versus open radical hysterectomy: a comparative study at a single institution. Gynecol Oncol. 2008 Dec;111(3):425-30. Epub 2008 Oct 16.
Piquion-Joseph JM, Navar A, Ghazaryan A, Papanna R, Klimek W, Laroia R. Robot-assisted gynecological surgery in a community setting. Journal of Robotic Surgery, 2009:1-4.
DeNardis SA, Holloway RW, Bigsby GE, Pikaart DP, Ahmad S, and Finkler NJ. Robotically assisted laparoscopic hysterectomy versus total abdominal hysterectomy and lymphadenectomy for endometrial cancer. Gynecologic Oncology 2008;111:412-417.
Payne, T. N. and F. R. Dauterive. A comparison of total laparoscopic hysterectomy to robotically assisted hysterectomy: surgical outcomes in a community practice. J Minim Invasive Gynecol, 2008;15(3): 286-291.
Boggess JF, Gehrig PA, Cantrell L, Shafer A, Ridgway M, Skinner EN, Fowler WC. A comparative study of 3 surgical methods for hysterectomy with staging for endometrial cancer: robotic assistance, laparoscopy, laparotomy. Am J Obstet Gynecol. 2008 Oct;199(4):360.e1-9.
Bell MC, Torgerson J, Seshadri-Kreaden U, Suttle AW, Hunt S. Comparison of outcomes and cost for endometrial cancer staging via traditional laparotomy, standard laparoscopy and robotic techniques. Gynecol Oncol. 2008 Dec;111(3):407-11. Epub 2008 Oct 1.

Content provided by Intuitive Surgical. For more information, please visit www.davincisurgery.com.

PN 874293 Rev A 12/10 U 6/30/11

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