Menorrhagia, or excessive menstrual bleeding, affects 22 percent of healthy women. According to OCH Regional Medical Center Staff Obstetrician/Gynecologist Jan Furniss, MD, this common problem is a frequent cause of iron-deficiency and is often treated with drug therapy, dilation and curettage (D and C), or hysterectomy in severe cases.

However, a new procedure, uterine balloon therapy (UTB), was recently approved by the Food and Drug Administration for treating certain patients with menorrhagia.

"UBT, a minimally invasive treatment that typically takes less than a half-hour, provides a cure for excessive bleeding in 85 percent of women who elect to have this procedure," Dr. Furniss said, adding that there is no surgical incision, and patients are discharged the same day, with most able to resume normal activities within a couple of days. "In most cases, menstrual bleeding will be reduced to light or moderate flow; some women may have only spotting while a few may have no bleeding at all."

She said UBT is now the treatment of choice for certain patients who have failed to find relief with drug therapy and wish for hysterectomy to be a last resort. According to Dr. Furniss, drug therapy, such as low-dose birth control pills or other hormones, can be effective in decreasing bleeding without the need for surgery. She noted that repeated, long-term dosing is sometimes required, as symptoms may return once the treatment is discontinued.

However, one should always try medical treatment before proceeding to a surgical procedure, she stressed.

"If drug therapy is unsuccessful, D and C is usually recommended. In this procedure, the cervical canal is expanded (dilation) to allow the surgeon to scrape the surface lining of the uterine wall (curettage)," Dr. Furniss said, noting that the efficacy of D and C reducing the menstrual flow is sometimes limited to the first few menstrual cycles after the procedure. "If a polyp, or small growth, is the cause of the excessive bleeding, the problem may be corrected during the D and C procedure by removing it."

Until the approval of UBT, hysterectomy was the only method available to totally "cure" menorrhagia.

Statistics show that hysterectomy is the second most frequently performed female surgical procedure in the United States, surpassed only by caesarean section.

According to Dr. Furniss, approximately 600,000 hysterectomies are performed in the U.S. each year, more than 30 percent of which are for menorrhagia.

Dr. Furniss said hysterectomy does provide a cure for menorrhagia, but it may be accompanied by some psychological side effects. In addition, a hysterectomy is a major surgical procedure requiring a minimum of four to six weeks of recovery time.

Dr. Furniss explained that uterine balloon therapy works by thermally destroying the endomentrial lining of the uterus in three phases. A balloon catheter is inserted vaginally, through the cervix, and into the uterus.

The balloon is inflated with sterile fluid, which is then heated in 87 degrees Celsius (188 degrees Fahrenheit) for eight minutes. After the treatment cycle is completed, the balloon is deflated and the catheter is withdrawn and discarded.

"Most UBT patients experience little to no pain; however, the most common post-procedural effects include mild to moderate cramping during the first day, which can be managed with an over-the-counter anti-inflammatory pain reliever," the physician said. "Most patients experience a pinkish and watery vaginal discharge for about two weeks to a month. This discharge is a normal part of the healing process."

Dr. Furniss stated that because UBT destroys the endometrial lining that must be intact to bring normal pregnancy to term, it generally renders the patient sterile.

However, because conception is still possible, it is recommended that patients who undergo the procedure use reliable contraception following the procedure or undergo sterilization procedure.

"UBT should only be performed on pre-menopausal women with benign-caused menorrhagia and who have completed childbearing," she said, noting the therapy is not for the following patients:

those who suffer from excessive menstrual bleeding due to structural causes such as fibroids, polyps   or other anatomical or systemic disorders

1. those who are pregnant or want to become pregnant in the future.
2. those with a history of latex allergy or who have demonstrated a sensitivity to latex materials.
3. those with known or suspected endometrial carcinoma (uterine cancer) or premalignant change of the endometrium.
4. those with anatomic or pathologic condition in which weakness of the myometrium could exist, such as history of previous classical caesarean section or transmural myomectomy.
5. those with genital or urinary tract infections at the time of the procedure.
6. those with an intrauterine device (IUD) currently in place.

"UBT is a wonderful new service OCH has made available to the community," Dr. Furniss said. "My colleagues and I know that it will make a dramatic difference in the lives of many of the women we serve." For more information about uterine balloon therapy, call the Starkville Clinic for Women at (662) 323-4427.