Minimally Invasive Techniques for Menstrual Problems - Sakra World Hospital
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February, 2019

Minimally Invasive Techniques for Menstrual Problems

Dr. Shanthala Thuppanna

For a number of women, menstrual discomfort and abnormal uterine bleeding can be common menstrual problems. Menstrual disorders affect not just a woman’s daily life and physical health, but her psychological well-being as well. Heavy bleeding could be idiopathic or abnormal uterine bleeding. In some cases, no obvious pathology is involved while in other cases, ovarian pathology might be involved. 

Around 10-35% of women suffering from menorrhagia (heavy menstrual bleeding) develop anaemia. On average, 10-30% of premenopausal women and 50% of perimenopausal women are affected by menorrhagia. 

What are the causes of menorrhagia?

Hormonal imbalance

During menopause, there will be a certain imbalance in the primary female hormones, estrogen and progesterone, which is a common cause of menorrhagia. 

Uterine fibroids

Uterine fibroids are benign growths in the uterus. This could be another cause of heavy and prolonged bleeding.

Endometriosis and adenomyosis

A condition where the cell growth is lined outside the uterus and in the ovaries is called endometriosis.  If the endometrial tissue growth develops inside the muscle layers of the uterus it is called adenomyosis.  Both these conditions can cause menstrual disorders and bleeding problems in women.

Medications and supplements

Tablets and medicines taken without a medical prescription can result in blood clots and bleeding. 


Uterus and cervix infection can result in painful or excessive menstrual bleeding. 

Non-communicable diseases,

Uterine, ovarian, or cervical cancer can be a reason for excessive bleeding. A thorough medical examination is required before a cause is established and a diagnosis is made.

How is menorrhagia diagnosed?

Certain test and scans are performed to diagnosed menorrhagia, such as:

1. Internal examination 
2. Ultrasonography 
3. Hysteroscopy 
4. Biopsy

A long thin camera is inserted inside the uterus to diagnose polyps, fibroids, and endometrial thickness. The curette, a small scraping device, is used to remove a layer of the endometrium to perform hysteroscopy.

What are the treatment options for menorrhagia?

The first choice for treatment is medication and most doctors recommend pain relievers to help manage the pain and other symptoms of menstrual disorders. The painkillers are advised based on the age and health condition of the patient. 

Surgery could be another option and is considered if the patient has:

1. Side effects from medications
2. Fibroids 
3. Pelvic infection
4. Endometriosis or adenomyosis

Surgery will reduce the bleeding and put an end to the pain completely. The surgery involves eliminating the causative factor such as any fibroids, polyps, or abnormalities of the uterine lining. In some cases, hysterectomy or removal of the uterus is suggested. 

Surgical procedures involved to treat menorrhagia

The advancement in medical technologies has made surgical treatment of menstrual disorders hassle-free. Minimally invasive techniques are used in hysteroscopy and laparoscopy methods. 

High-definition (HD) 3D cameras mounted on devices help surgeons view with enhanced clarity and depth of vision. These minimally invasive techniques involve minimal cuts, negligible blood loss, faster recovery, and less hospital stay. 

Endometrial ablation

This technique involves removing or destroying the uterine lining using microwaves. A thin slender instrument called a hysteroscope is inserted inside the uterus through the birth passage to view and perform the ablation. The procedure is performed under local anaesthesia. 
Endometrial ablation results in a reduced hospital stay and no risk of health complications when compared to hysterectomy, and it’s cost-effective. 


This surgical procedure involves the removal of fibroid using laparoscopy, which can remove a great number of fibroids. It can be performed using hysteroscopy under local anaesthesia with no cuts. 


This surgical procedure involves the removal of the uterus and it was once a common treatment procedure for menorrhagia. These days, keyhole surgery and laparoscopic hysterectomy are preferred and recommended by a majority of surgeons. 

Laparoscopic procedures such as hysteroscopy require a great deal of training and expertise. At Sakra World Hospital, our experts are equipped with the latest medical technology to facilitate the best care for our patients. We also encourage our doctors to be up to date with the best practices and to uphold global standards of care.

Menstrual disorders can cause women untold pain. Don’t be afraid to speak up and seek medical help for menstrual discomfort, excessive menstrual bleeding, or other menstrual problems. Speak to one of our experts at Sakra World Hospital for prompt and effective treatment of menstrual disorders.




Dr Shanthala Thuppanna

Visiting Consultant - OBG

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