Irregular periods impact the lives of more than 10 million American woman each year, and can greatly affect a woman's fertility, day-to-day living, and overall health. Many women don't seek help for irregular periods due to embarrassment or not realizing that help is available. However, help is
Mile Bluff's Women's Health Team
is made up of providers who specialize in gynecology and are trained to diagnose and treat conditions that are unique to women. Mike Pech, MD, FACOG
, Katherine Leigh Hilsinger, MD
, and Maria Wolf, APNP
, seek to find the best solutions for their patients who are experiencing irregular periods and other female-specific issues.What is the first step in treating patients with irregular periods?Maria Wolf, APNP (MW):
When a patient comes to me concerned about an irregular period, we start by talking about the characteristics of her period. It's important to distinguish if the patient's periods occur monthly and an egg is release, or if the periods are irregular and do not follow a schedule.
If patients suspect their periods are irregular, I really encourage them to use a calendar to track how long their periods last and occur, how heavy the bleeding is, and what level of pain they experience. Generally, irregular periods are caused by a hormonal imbalance, but stress can also cause a period to be late or not come at all. At the first appointment, we will talk about all of these factors to determine the next course of treatment.After it's established that a woman is experiencing irregular periods, then what can be done?Katherine Leigh Hilsinger, MD (KLH):
Next we try to figure out why a woman is having an irregular period, as there can be a number of causes. We can do a number of tests, including blood work and ultrasounds to look at the uterus. We can also do biopsies to rule out any cancerous conditions. In our office we also have a specialized camera that we can use to look inside the uterus to see if there is anything that could cause irregularity.
There really are a lot of steps we can take in the office before turning to surgery and further treatment methods.What is the most common treatment for irregular periods?Mike Pech, MD (MP):
The biggest thing we need to determine when treating irregular periods is whether the irregularity is because of the ovaries or because of the uterus.
If the issue is being caused by the ovaries, the patient generally has a hormonal imbalance. In this situation, we can use birth control pills to make a patient's cycle regular again. Birth control pills are usually a safe choice, unless the patient is over 35 years old and a smoker. If the patient is trying to get pregnant, there is another medication that can be given to kick the ovaries into gear to make a woman ovulate. Most of the issues surrounding irregular periods are very treatable.When is a period considered heavy, and what are some simple treatment options?MW:
A period is considered heavy when a woman saturates a maxi-pad or tampon within an hour, or if she is passing quarter-sized clots in her menstrual flow. Many times, heavy bleeding can interfere with a woman's quality of life. If this is the case, we work with patients to determine the cause of the heavy bleeding, and come up with an individualized treatment plan.
Most commonly, we treat heavy periods with birth control pills, unless there are concerns about issues regarding hormone levels. If a patient is over age 35 and a smoker, the birth control pill probably isn't the best choice for treating heavy periods. Even if a woman has undergone sterilization, birth control can still be an option for treating heavy bleeding.
There are some additional hormonal and non-hormonal treatment options available as well.When would surgery be used to treat heavy periods?MP:
If we find some abnormalities in the uterus, like a polyp, we can go in surgically to remove the problem. That can often make a patient's periods return to normal. There are additional surgical options as well, including endometrial ablations.What is the next surgical step in treating heavy periods?KLH:
If other treatments do not work, the next step is a hysterectomy. The most common reasons for a hysterectomy in the United States are heavy bleeding and pelvic pain. It really becomes a quality of life issue.
Recently, a national study was done which showed that 54 percent of hysterectomies were performed abdominally. This means a big incision was made, the recovery was at least two months, and there was a big impact on a woman's quality of life. However, with the development of surgical technology and techniques, there are minimally-invasive and vaginal options available that allow patients to return more quickly to their normal routines.
At Mile Bluff, Dr. Pech and I are advanced laparoscopic surgeons and we perform minimally-invasive and vaginal hysterectomy procedures right in Mauston. We find that these types of procedures leave less scarring, have a shorter recovery time, and fewer complications. In the past two years or so, there has only been one hysterectomy case that was not performed laparoscopically or vaginally here at Mile Bluff. Compared to national averages, we're proud that we offer less stressful options for our patients.
If you're concerned about irregular or heavy periods, or would like to learn more about the women's health services at Mile Bluff, call 608-847-5000 today.