New hope for women

Dr Liang with his colleague and gynaecologist Dr Bevan Brown (who was co author of the report on the success of UAE)
Dr Liang with his colleague and gynaecologist Dr Bevan Brown (who was co author of the report on the success of UAE)

While it’s rarely talked about, and often suffered in silence, for at least 1 in 4 women, heavy menstrual bleeding (HMB) can be crippling, severely effecting their quality of life. It’s worse when periods are painful.

The physical impact and the effects on confidence and self-esteem can take a toll on women’s ability to study, work, form relationships, play sport, and in extreme cases, their willingness to leave their homes.

Hysterectomy is often proposed as the only solution.

What many women don’t realise is that they may have a condition that can be treated with an alternative procedure.

Adenomyosis is a little known condition most commonly found in women who have previously given birth, and are aged 35-50. With not much knowledge of it, cause unknown, and non-specific symptoms, adenomyosis is often undiagnosed.

The condition causes the lining of the uterus to grow into the uterine wall worsening with each menstrual cycle, thickening and enlarging, causing painful, heavy periods.

It is similar but different to endometriosis which causes tissue to grow on the outside of the uterus.

Frustratingly, for up to 70% of women who have chosen to have a hysterectomy because of the painful and inconvenient symptoms, adenomyosis is discovered after the procedure. If they had known what their condition was, and that there was an option, they may not have chosen hysterectomy.

How has it been treated until now?

Conservative treatment methods include progestrogen pills or IUD ( Mirena) for HMB and nonsteroidal antiinflammatories for pain. Failing these, hysterectomy is often offered as the next option. However for women still wanting to have children or others worried by the risk of surgery, it hasn’t been an ideal alternative.

What’s the new option?

Uterine artery embolisation is a non-surgical option for adenomyosis providing a beacon of hope to women. Traditionally used to successfully shrink fibroids, in recent years uterine artery embolisation has been used to treat adenomyosis in the uterus.

A recent study that followed 117women treated this way for 2 years after UAE showed that 90% of patients were happy with the outcome with a resolution of their heavy menstral bleeding and had a remarkable reduction in pain.

UAE is performed under local anaesthetic, involving the insertion of small catheter into a main artery in the groin through blood vessels to the uterus. Small particles are injected into the bloodstream which block the blood supply so that the adenomyotic tissue will shrink and die. Normal uterine tissue remains unharmed.

The procedure requires one night’s stay in hospital and a few days rest at home to recover.

The implications from the research are profound. UAE has been found to be safe and effective in treating adenomyosis related heavy menstal bleeding and severe period pain. If traditional or conservative treatments have failed women now have a nonsurgical option.

The study co authored by San doctors, interventional radiologist Dr Eisen Liang and gynaecologist Dr Bevan Brown shows the success of the procedure and is published in the Australian and New Zealand Journal of Obetetrics and Gynaecology adding to the international literature on treating Andemyosis.

Dr. Eisen Liang is the Director of Sydney Interventional Radiology at Sydney Adventist Hospital Suite 407 San Clinic For more info, visit Phone: 9473 8728 Fax: 9473 8721

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