Procedure / Description

Benefits / Effectiveness

Impact on Fertility

Side Effects / Drawbacks

Risks / Complications

Drug Therapy

· Medications / hormonal therapy with birth control pills or progesterone

· Often prescribed as a first step when attempting to bring heavy periods under control

· Can help reduce heavy or prolonged menstrual bleeding

· Can be effective in decreasing bleeding without the need for surgery

· No effect on fertility when discontinued

· Minor—headaches, breast tenderness, and weight gain are common

· Long-term use is often required

· Serious complications are rare

Dilation & Curettage (D&C)

· Surgical procedure in which doctor widens (dilates) opening of the cervix and scrapes away tissue from the lining of the uterus (curettage)

· Not a long-term solution for heavy periods because the endometrium grows back

· Can result in reduction of heavy flow for the next few cycles

· Outpatient procedure

· Normally, no effect on fertility

· Mild cramping, spotting, or light bleeding

· Potential complications associated with general anesthesia, if used

· Perforation or rupture of the wall of the uterus

· Infection and injury to the cervix

Endometrial Ablation

· Surgical procedure that removes the endometrium (inner lining of the uterus)

· Very little of the endometrium grows back, and heavy bleeding is much less likely to continue

· Minimally invasive one-time treatment

· Periods either return to normal, are much lighter, or stop completely

· Often the only treatment you will need for bleeding

· May be performed under local anesthesia in the office

· Not indicated for women who plan to get pregnant

· Requires continued use of contraception until menopause

· If you do get pregnant, complications may occur

· Short term cramping, pelvic pain, nausea if general anesthesia is used

Rare

· Blood loss or perforation of the uterus

· After the procedure, any pregnancy may be risky

· Potential complications associated with general anesthesia if used

Hysterectomy

· Surgical removal of the uterus

· Hysterectomy can be performed:

-Abdominally-through incision in lower abdomen

-Vaginally-through incision in the vagina

-Laparoscopically-through tiny incisions using small instruments

-Laparoscopic supracervical hysterectomy

· Will cure heavy bleeding and eliminate periods altogether

· Because the uterus is removed completely, you can no longer become pregnant

· Major surgery-must be performed under general or regional anesthesia

· If ovaries are removed, onset of menopause is immediate

· Hospital stay is required

Rare:

· Potential blood loss, infection, and damage to other internal organs.