Dr. Duncan Burkholder Discusses Abnormal Menstrual Bleeding

Dr. Duncan Burkholder Discusses Abnormal Menstrual Bleeding


One of the most common things that gynecologist
deal with, is abnormal menstrual periods and we sort of subdivide them into two
groups. The regularity of the cycle really has to do more with ovaries and
hormones in the body and then the heaviness and the length of the cycle has
more to do with something going on with the uterus. First thing we want to know
is, are you having regular cycles. If the cycles are regular in a premenopausal woman
that means all the hormones are in balance, not just that the ovaries are in balance, but
the pituitary gland and the midbrain has to be in balance, the thyroid gland has
to be in balance, the adrenal glands above the kidney has to be in balance as
well as the ovaries have to be in balance to have regular cycles. It’s a
sign that all the hormones are in balance and it’s a sign of good health and vice
versa. If a woman is not having regular cycles, somethimg is
out of balance and it should be checked, even in teenagers. If a woman is having
heavy menstrual cycles or prolonged menstrual cycles, sometimes it can be the
hormones are out of balance but often it implies that something’s wrong with the
uterus itself. Another thing that a lot of people forget is, you know how
much blood a woman’s supposed to lose each month on her menstrual period? About an
egg or less. It’s not that much and it’s surprising to me how many women come in
and they’ll say oh my goodness I’m passing clots or oh my goodness I have
to change my protection every hour or two. Oh! I have to use double protection or I can’t
even leave the house. It’s like my gosh. You can’t live your life like
that because it’s sucking so much energy out of you and it’s hard on your body. You know not
only is it exhausting but it’s hard for your body to build that blood
back. So we need to make the right diagnosis and try to help people fix that now. The
hard news is, we gynecologits don’t have a lot of tools in our toolbox when
a woman starts bleeding real heavily. And I will tell you what the three tools are. First one
is birth control pills and it may help but it doesn’t cure the problem. The
second one is, there is a procedure called endometrial ablation that will cauterize
the inside of the uterus and it only takes 90 seconds to do that surgery and
it’s a great breakthrough that has been available for the last few years and
then last but not the least, many women of course need a hysterectomy to correct it
and a lot of doctors have been accused of being overly aggressive about doing
hysterectomies but the fact is, it’s not that we are holding back the good stuff. It is
just that we don’t have any other options to offer and we let the women choose
what she prefers. We do not push anybody to the operating room. That’s their
choice.

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