Gynecological bleeding

Individualized treatment according to the specific cause of the abnormal bleeding is highly recommended. Age and whether the woman wants to have children are also important considerations.

In the case of dysfunctional uterine bleeding, that is to say, that due to anovulation, the treatment will be fundamentally medical, by taking drugs (either taken orally or used in the form of an intrauterine device) that restore ovulation or allow control of the bleeding.

If these treatments fail, a useful alternative is endometrial ablation, that is, the exeresis of most of the endometrial tissue, which would allow a decrease in the amount of bleeding. It is performed hysteroscopically under general anesthesia. It is important to exclude serious endometrial lesions, mainly endometrial cancer, before performing this procedure.

The use of Caviterm, which produces endometrial atrophy by using high temperature distilled water instilled by an instrument specifically designed for this purpose, has also been recently described. This treatment should be reserved for those patients who do not have fertility desires. It is performed hysteroscopically under general anesthesia. It is important to exclude serious endometrial lesions, mainly endometrial cancer, before performing this procedure.

In the case of chronic diseases that induce abnormal uterine bleeding, the therapeutic approach should be directed primarily to the treatment of that disease, with measures similar to those described above being helpful.

Structural abnormalities of the uterus or endometrium will have a specific treatment, fundamentally of a surgical type, either using hysteroscopy, such as the exeresis of myomas and polyps; or by means of open surgery (laparotomy), with the possibility of only removing the myoma, if this is the cause of the bleeding (which is called myomectomy); or, in extreme circumstances, the exeresis of the uterus (hysterectomy).