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BEFORE A HYSTERECTOMY, CONSIDER ALL YOUR OPTIONS!

Nearly 600,000 Hysterectomies are performed in the US each year; many are for heavy periods. Serving Burbank, Glendale, Sherman Oaks, Los Angeles and the surrounding communities, Steven A. Rabin, MD is a gynecologist dedicated to helping you make an informed decision about your care options. Do you have fibroids or heavy periods?  Are you  flooding at times, passing clots, soaking your double protection and then your clothes or bed sheets?  If medical treatments such as hormones or birth control pills don’t help or you cannot tolerate them, and if other options such as the Mirena IUD or progesterone-only therapy have been considered or tried, then hysterectomy is often presented as the next step in your therapy.

Are you interested in learning about…

  • An Oral Medication (pill) taken only during your period
  • A Non-Hormonal, FDA-Approved treatment that is successful 80% of the time?
  • You’ll know if it works the first time you try it!
  • Minimally Invasive Procedures (No Scars!)
  • Visit Dr. Rabin to see which options might be right for you!

What would you say to…

  • A minor procedure that is 85% effective at reducing or eliminating your periods?
  • No incisions
  • Minimal recovery time (1 day)

In less than an hour (the procedure takes about 20 minutes) you can be on your way to a hormone-free, scar-free alternative to hysterectomy for Menorrhagia (Heavy Periods).

Dr. Rabin is pleased to offer endometrial ablation as an alternative to hysterectomy for treatment of heavy periods.  Novasure, HerOption, and Hydrothermal Ablation (HTA) are quick and safe treatments for Menorrhagia- abnormally heavy menstruation. This treats the only the inner lining of the uterus (the endometrium).  This procedure can be performed as an outpatient procedure.  Endometrial ablation does not involve hormones, it has a high success rate and has a quick recovery time—most women return to their regular activities the next day. This will not be the solution for every case of heavy bleeding. Hormone therapy, Mirena IUD and even hysterectomy may be the right treatment in certain cases.  Ask Dr. Rabin if endometrial ablation may be right for you.

We will listen to you, provide excellent testing, ultrasound, specialized imaging such as saline enhanced sonography and determine your unique situation.  Then we will offer a variety of options.  We will help you find the solutions that match your situation and your goals.

Important factors that help determine which options are right for you:

  • Desire for future pregnancy
  • Form of birth control used
  • Shape of uterus
  • Presence of fibroids or polyps
  • Problems with the endometrium (hyperplasia, atypia)
  • Previous response to hormone or medical treatments
  • Degree of associated pain

It is important to work with a physician who is experienced in putting together all this information along with your personal preferences to offer you the specific options that are appropriate for you to consider.

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What is a hysterectomy?

Hysterectomy is the name of the procedure where the uterus is removed.  This can be done in a number of ways according to the size of the uterus and based also on a number of other factors.  By using a laparoscopically assisted approach, we can remove the uterus vaginally and minimize the scars on your skin and speed up the recovery time.  Every woman’s situation is different.  This will be decided during your visit with Dr Rabin.  He is an experienced gynecological surgeon with a long history of excellent outcomes.

Consider getting another opinion and explore all of your options. Endometrial ablation, myomectomy, and hormonal therapies are some of the alternatives that might be appropriate in your unique situation.

 

 

Take The Heavy Bleeding Quiz:

Circle Yes or No

Y   N    1. Does your period last longer than seven days?

Y   N    2. Do you use more than three pads or tampons per day?

Y   N     3. Do you need to double up on feminine protection?

Y   N     4. Do you become fatigued due to your heavy bleeding?

Y   N     5. Do your heavy periods affect your social life, fitness or sexual intimacy?

Y   N     6. Do you miss work because of your periods?

Y   N     7. Does your menstrual flow include large clots?

Y   N     8. Do you avoid leaving home for fear of accidents?

Y   N     9. Do you avoid wearing light colored clothing during your period?

Y   N     10. Does medication (birth control pills) fail to ease your symptoms?

Menstrual History

1. How many consecutive days do you bleed per cycle? __________days

2. How many days do you bleed per month?     ___________days

3. How regular is your menstrual bleeding?  ___Irregular  ___Regular  ____Absent

4. What is the duration of your bleeding?    ___Prolonged  ___Normal ___Shortened

5. How frequent is your menstrual bleeding?  ___Frequent ___Normal ___Infrequent

6. How would you describe the volume of your menstrual bleeding?

                                                                             ___Heavy ___Normal ___Light

7. When did your heavy periods begin?               ___Teens ___20’s ___30’s   ___40’s

8. Have you ever had a post-partum hemorrhage?         ___Yes   ___No   ___Not Sure

9. Have you ever had bleeding associated with a surgery? ___Yes  ___No  ___Not Sure

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How it Works

What can HerOption do for you?

Each month during your period, you shed your uterine lining (endometrium). This shedding process is what causes normal menstrual flow.

HerOption Office Cryoablation Therapy is a safe and effective ablation procedure that uses sub-zero temperatures (cryoablation) to reduce your heavy periods to normal levels.

The cold temperatures destroy the endometrium. With the endometrium reduced or eliminated, there’s less tissue to shed each period. The result? Dramatically less menstrual bleeding.

Cryoablation—a proven ablation technique

Cryoablation is a time-tested treatment with proven success in treating many medical conditions.  Dr. Rabin has been performing endometrial ablations in his Atlanta clinic for over 16 years.  Many different techniques have been discovered over the years and only the most effective and safe procedures are currently offered.

Other ablation processes work through energy or heat. Cryoablation uses sub-zero temperatures to reduce or eliminate the uterine lining. The natural analgesic affect of these low temperatures reduces patient discomfort during the procedure. Plus, ultrasound guidance during the procedure lets your doctor monitor the therapy as it happens, offering an additional level of safety.

Cryoablation offers additional long-term benefits, including:

  • minimal intrauterine scarring (this feature may help your doctor identify future issues more quickly)
  • improvement of pain and mood related to PMS

Preparing for the Procedure

No hospitals. No hormones. No surgery.

HerOption Cryoablation is safe, simple and effective. It’s also the only endometrial ablation therapy approved for use in the comfort of your doctor’s office.

Steps of the treatment process
  1. Eat a very light meal prior to your appointment.  Take the pain medications Dr. Rabin has prescribed for you about 2 hours before the procedure is scheduled to begin.
  2. Your bladder will need to be full so we can monitor the treatment progress using an ultrasound. Drink two 8-oz. glasses of water before you arrive and do not use the restroom until after the procedure.
  3. Dr. Rabin may give you additional pain medication and will also use local anesthetic like the dentist would typically use.
  4. After some preliminary measurements, Dr. Rabin will insert a slender probe through your vagina into your cervix and into the uterus. The probe is so thin that it often requires little or no cervical dilation, minimizing discomfort.
  5. Once the probe is in place, the cooling process begins. Ultrasound is used to monitor the placement and progress of the procedure.  This maximizes the safety. The probe freezes the uterine tissue symmetrically around its tip towards one side of the uterus. After several minutes, your doctor will warm the endometrium for one to two minutes and then repeat the freezing on the adjacent areas of the uterus.  In the case of a larger uterus, a third freezing may take place.
  6. After a final brief warming cycle, the procedure is complete. The entire process takes approximately 20-30 minutes. (Times will vary.)
Will it hurt?

Most women don’t experience pain during the procedure. You may, however, initially feel mild pressure or a cramping sensation (similar to menstrual cramps). You may have some cramping or pain after the procedure as the cooling effect wears off.  Dr. Rabin will prescribe anti-inflammatory medication ahead of time can help reduce any discomfort. Please use the anti-inflammatory medications with your first meal or snack after the procedure and use them only as directed.

What are the risks?

Every medical treatment has potential risks and complications.   Speak with Dr. Rabin to make sure you understand the potential complications and benefits of Cryoablation.

Insurance coverage information?

Most private insurance covers Her Option Office Cryoablation Therapy. We will have done our best to provide you with information about your insurer�s coverage prior to scheduling the procedure. In some cases a small office co-pay is all that’s required (after your deductible has been met).

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Risks and Contraindications

Summary of Warnings, Precautions and Contraindications for the HerOption� Cryoablation Therapy System

The Her Option Cryoablation Therapy System is medical device that uses sub-zero temperatures to destroy the tissue lining the uterus (endometrium). The procedure is intended for pre-menopausal women with excessive bleeding due to benign causes for whom childbearing is complete.

The device is contraindicated for patients who:

  • intend to become pregnant
  • use an IUD
  • suffer from uterine cancer
  • have an active urinary tract infection or pelvic inflammatory disease
  • have certain types of uterine abnormalities.

Every medical treatment has risks and complications. Review these with Dr. Rabin.

Menstrual History

Keep a history of your heavy periods.

If you’re concerned about abnormal uterine bleeding or other problems with your cycle, it’s time to discuss all of your options with Dr. Rabin.

The best way to take control of your heavy periods is to talk to your doctor. Tell him or her about the way abnormal uterine bleeding affects your life. For better insight into your symptoms, share these results at your next visit.

The more information you can provide for your doctor, the better. Keep track of your periods, then bring your notes to your next appointment.

Abnormal Uterine Bleeding (AUB)

What is abnormal uterine bleeding (AUB)?

Many women experience heavy menstrual bleeding at some point in their lives. But for one in four women, every cycle is heavy—and that’s not normal. Doctors call this condition “abnormal uterine bleeding (AUB)” or “Menorrhagia.”

How heavy is too heavy?

Although every woman experiences her period differently, most doctors define a normal, healthy period by a few standard criteria.

Normal bleeding:

  • occurs about every 25-31 days
  • last 4-5 days
  • totals 2-3 tablespoons

Abnormal uterine bleeding (AUB):

  • can last longer than seven days
  • may require frequent change of protection, or double protection
  • may include large blood clots in your flow
  • may cause tiredness, fatigue or shortness of breath (symptoms of anemia)
How to tell if you suffer from AUB

New guidelines from the American College of Obstetricians and Gynecologists suggest that if your heavy periods negatively impact your life and you believe they’re a problem, you should discuss these issues with your gynecologist.

Signs and Symptoms

You don’t have to live with heavy periods.

If you’ve experienced one or more of the following symptoms, speak with Dr. Rabin. Your heavy periods could be the result of a condition called abnormal uterine bleeding.

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Some of the most common symptoms of AUB include:

  • bleeding that soaks through one or more sanitary pads or tampons every hour for several consecutive hours
  • bleeding so heavy you need to double up on sanitary protection
  • bleeding that causes you to change protection during the night
  • a period lasting longer than seven days
  • menstrual flow containing large blood clots
  • heavy periods that interfere with your regular lifestyle (i.e. physical activities, sexual intimacy, career, recreation, self-confidence)
  • constant pain in your lower abdomen during your period
  • severe cramps or headaches during your period
  • irregular periods
  • tiredness, fatigue or shortness of breath (symptoms of anemia)
Higher risk patients

Certain women carry a greater risk of AUB. This high-risk group can include women who:

  • have a history of hormonal imbalance
  • suffer from thyroid problems or diabetes
  • are over 35
  • are young, and experienced their first period 12-18 months ago
  • come from a family with a history of bleeding disorders

Living with AUB

How can you cope with AUB?

If you suffer from heavy periods every month, you already know AUB affects every part of your life from your wardrobe to your sleep schedule to the way you socialize.

But you don’t have to plan your entire life around your period. There are many treatment options for women suffering from AUB.  Ask Dr. Rabin about finding the one that’s right for you.

Self-care tips

You can help minimize the discomfort and embarrassment of heavy periods with these self-care tips.

Keep track. Complete a menstrual history or record the number of pads and tampons you use throughout your period. Dr. Rabin will use this information to understand how much blood you lose in each cycle.

Eat right. Talk to your doctor about following an iron-rich diet or taking iron supplements to minimize anemic effects.

Chill out. Relaxation isn’t a cure for excessive menstrual bleeding, but putting yourself under too much stress only adds to your physical and mental discomfort.

Talk about it. Share your story with someone you trust. You may find that a friend or relative has experienced heavy periods as well.

Rest up. If bleeding is extremely heavy and disrupts your normal lifestyle, your doctor may recommend more rest.

Causes

What causes abnormal uterine bleeding (AUB)?

Part of staying healthy means understanding what’s causing your heavy periods. Pinpointing the cause(s) can help your Dr. Rabin decide which treatment options may be right for you.

Causes of abnormal uterine bleeding (AUB)

Hormonal imbalances – If your body doesn’t maintain the right balance of estrogen and progesterone, the lining of your uterus (endometrium) can build up excessively. During your period, this excess can cause heavy bleeding. These hormone imbalances are most common among adolescent girls and women approaching menopause.

Benign (non-cancerous) growths like fibroids or polyps – Uterine growths can appear during your childbearing years and cause heavier, longer or irregular periods.

 Complication from pregnancy – An ectopic pregnancy (implantation of a fertilized egg in the fallopian tube instead of the uterus) can occasionally cause heavy periods. A single heavy period that’s late may be the result of a miscarriage.

Medications – Some drugs—especially anticoagulants (medications that prevent blood clotting) and anti-inflammatories—can lead to heavier, longer periods.

Bleeding disorders – Certain disorders impair blood clotting, leading to heavy bleeding and longer periods. These disorders are serious and need medical attention.

Use of Intrauterine device (IUD) – Abnormal Uterine Bleeding is a common side effect of using IUD for birth control. If  your IUD is the cause of your heavy periods, your doctor may need to remove the device.

Abnormal ovary function – If your ovaries don’t produce, mature or release eggs (anovulation) a hormonal imbalance can occur, leading to AUB.

Adenomyosis – Most common among middle-aged women who have had many children, this condition occurs when glands from the endometrium grow into the uterine muscle. Heavy bleeding and pain can result.

 Cancer – Although it’s rare, certain female reproductive cancers like uterine cancer, ovarian cancer and cervical cancer can cause heavy periods.

Other illnesses – Certain medical conditions can cause or increase your risk of AUB. Examples include thyroid problems, endometriosis, lupus, liver or kidney disease and pelvic inflammatory disease (PID).

Untreated AUB can also cause various health conditions. For example, untreated AUB can lead to anemia, which in turn can lead to further health problems. AUB can also contribute to feelings of social isolation and depression, compromising your quality of life.

Treatment Options

Living with heavy periods? You’ve got options.

If you suffer from AUB, it’s time to sit down with Dr. Rabin and plan for a healthier, more comfortable future.

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Treatment options for AUB

Doctors can treat heavy periods safely and successfully using a variety of methods. Link to this Treatment Comparison Chart:

Treatment Comparison Chart

Your many options include:

  • Hormone therapy
  • Dilation and Curettage (D & C)
  • Hysterectomy
  • Myomectomy (removal of fibroids)
  • Endometrial Ablation: D
Which option is right for you?

You and Dr. Rabin will need to consider several factors before making a decision about treatment, including:

  • cause of bleeding
  • amount and frequency of bleeding
  • specific ways heavy periods affect your life
  • possibility of future pregnancies
  • benefits of a one-time treatment vs. ongoing therapy
Her Option advantage

Her Option in-office Cryoablation procedure uses cryoablation to reduce or eliminate menstrual periods in most women. This type of treatment can free you from abnormal uterine bleeding without major surgery or hormones.

Important safety information

Her Option is not recommended for everyone. You’ll need to be evaluated by Dr. Rabin to find out if it’s right for you.

You will not be a candidate if you:

  • intend to become pregnant
  • use an IUD
  • suffer from uterine cancer
  • have an active urinary tract infection or pelvic inflammatory disease
  • have certain types of uterine abnormalities.

Every medical treatment has risks and complications.

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Talking to Doctor Rabin

Talk to Dr. Rabin today about AUB.

The best way to take control of your heavy periods is to talk to Dr. Rabin. Discuss the way abnormal uterine bleeding affects your life.

Find the right doctor.

Read what other women have to say about Dr. Rabin (Click on Testimonials). Steven A. Rabin, MD has 19 years of experience treating women who suffer from excessive menstrual bleeding.  He has been performing endometrial ablation for over 16 years.  Many different techniques have been developed over that time.  Dr. Rabin performs the most modern, safe and effective techniques available.  Dr. Rabin even helps other physicians learn about these newer techniques.

Take the Heavy Bleeding Quiz 

Take the Heavy Bleeding Quiz and the complete the Menstrual History. Record your answers. Then track your cycle in a notebook. Jot down questions and concerns as they occur to you, and bring the list to your visit—you don’t have to wait for Dr. Rabin to ask.

Be as descriptive as possible in your notes, including information about:

  • number of days of bleeding each month
  • type of protection you need each day (i.e. light flow tampon, heavy pad, double protection)
  • how frequently you change protection each day
  • any clotting in your flow
  • symptoms of fatigue, cramps, moodiness

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Work together as a team.
Once you agree on a course of treatment for heavy bleeding, take any prescribed medications as directed, and offer honest, complete feedback on your condition. Ask specific questions about medical diagnoses and treatment recommendations.

Take an active role in your health.
Spend time researching your treatment options on your own. Talk to friends and family who may have had similar experiences. Before you decide on a course of treatment, make sure you understand the benefits and drawbacks of the various treatment options available for abnormal uterine bleeding.

Set realistic expectations and evaluate results.
Talk about your expectations for the treatment you choose and set appropriate goals with your doctor. Decide what type of feedback will help Dr. Rabin understand whether you’re getting the results you hoped for.

With HerOption Office Cryoablation Therapy, you should start experiencing bleeding that falls within the range of a normal period after approximately two to three cycles. In one study, 88% of women experienced normal periods or better. In some cases, women experience more dramatic results, with extremely light (or even absent) periods resulting after the treatment.

Understand important safety information.
Her Option is not recommended for everyone. You’ll need to be evaluated by Dr. Rabin to find out if it’s right for you.

You will not be a candidate if you:

  • intend to become pregnant
  • use an IUD
  • suffer from uterine cancer
  • have an active urinary tract infection or pelvic inflammatory disease
  • have certain types of uterine abnormalities.

Every medical treatment has risks and complications.

Know what your doctor will be looking for.
http://captivatewebdesign.com/clients/drrabin/wp/wp-content/uploads/2012/06/AGS_Lady_05.jpgDr. Rabin can only make an accurate diagnosis after ruling out other menstrual disorders, medical conditions or medication side-effects as possible causes of heavy bleeding.

We may start by asking about your medical history and your menstrual cycles. We may perform a physical exam, or recommend one of the following tests:

  • Blood tests screen for anemia, thyroid disorders or blood-clotting abnormalities.
  • Pap tests detect infection, inflammation or changes that may be cancerous or may lead to cancer.
  • Pelvic exam let your doctor check your internal organs for abnormalities.
  • Endometrial biopsy rule out cancer or other serious conditions.
  • Ultrasound scan (sometimes Saline-Enhanced Ultrasonography) to produce images of your uterus, ovaries and pelvis. The saline enhanced exam can show us if there are polyps or submucous (inside the uterine cavity) fibroids.
  • Hysteroscopy to take a picture of your uterus using a small camera inserted through your cervix.

Check in your junk mail if you do not see something in your normal “in-box.”

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