Monthly Archives: February 2024

If your periods are so heavy and or prolonged that they disrupt your normal daily activities, you may have excessive menstrual bleeding also known as menorrhagia. Symptoms of menorrhagia may also include cramping, pelvic pain and, in severe cases, anemia.

Excessive menstrual bleeding is a common condition that occurs for many of reasons. Two of the most common causes are a hormonal imbalance and uterine growths.

Hormonal Imbalances

Your menstrual cycle is controlled by hormones, including estrogen and progesterone. When these hormones are out of balance, they can cause heavy periods or bleeding between periods. Causes of hormonal imbalances may include:

• Hormonal changes in teens and in women nearing menopause
• Diabetes
• Thyroid disease
• Obesity
• Stress
• Strenuous exercise
• Anorexia (eating disorder)

Types of Uterine Growths

• Fibroids – benign (non-cancerous) growths in or near the uterus
• Polyps – growths that attach to the inner wall of the uterus and protrude into the uterine cavity

Treatment Options

There are medication and non-invasive treatment options available. Treatment options could include NSAIDs, oral contraceptives, oral hormones or a hormonal IUD.

You may need surgical treatment for menorrhagia if medical therapy is unsuccessful. Treatment options include:

Dilation and Curettage (D&C)

During this procedure, your doctor opens (dilates) your cervix and then scrapes or suctions tissue from the lining of your uterus to reduce excessive menstrual bleeding.

Uterine Artery Embolization

For women whose menorrhagia is caused by fibroids, the goal of this procedure is to shrink any fibroids in the uterus by blocking the uterine arteries and cutting off their blood supply.

Myomectomy

This procedure involves surgical removal of uterine fibroids.

Endometrial Ablation

This procedure involves destroying (ablating) the lining of your uterus (endometrium). The procedure uses a laser, radiofrequency or heat applied to the endometrium to destroy the tissue.

Endometrial Resection

We use the Myosure procedure to remove the growth on your uterus while preserving form and function of the uterus. Both endometrial ablation and endometrial resection benefit women who have very heavy menstrual bleeding.

Hysterectomy

This surgery to remove your uterus and cervix is a permanent procedure that causes sterility and ends menstrual periods. Hysterectomy is performed under anesthesia and requires hospitalization. Additional removal of the ovaries (bilateral oophorectomy) may cause premature menopause.

Many of these surgical procedures are done on an outpatient basis. Although you may need a general anesthetic, it’s likely that you can go home later on the same day. An abdominal myomectomy or a hysterectomy usually requires a hospital stay.

For those who require a surgical procedure, traditional open GYN surgery uses larger incisions for access to the uterus and surrounding anatomy which, ultimately, results in more pain, trauma and a longer recovery process.

Minimally Invasive Robotic-Assisted GYN Surgery

Drs. Pierce, Ung and Gamburg are the Princeton area’s most experienced GYN surgeons using the da Vinci® XiTM Surgical System for minimally invasive gynecologic surgeries.

Minimally invasive procedures like robotic-assisted GYN surgery are especially promising for women who would like to have children in the future. For instance, when removing fibroids – regardless of the size and location of the fibroid – the surgeon is able to better see where they are operating and to make precise movements to remove it, preserving the delicate structures of the pelvis and decreasing the chance of future complications.

The overall benefits of robotic-assisted GYN surgery include:

• Fewer complications
• Less blood loss and risk of infection
• Significantly less pain and scarring
• Shorter recovery time for a quicker return to normal activities
• A less invasive surgical option to get you back to your daily life

By operating with the da Vinci® XiTM Surgical System, our patients who suffer from excessive menstrual bleeding see noticeable benefits because incisions are smaller, pain is minimized and recovery time is reduced.

While clinical studies support the effectiveness of the da Vinci Xi Surgical System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Xi Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

You don’t have to suffer from excessive menstrual bleeding any longer. To learn more about your treatment options, Contact Us for an Appointment HERE.

We are one of the Princeton area’s leaders in establishing a model of care using both the skills of both the midwife and those of physicians in a collaborative manner to produce the best outcomes for our patients and their families. Our midwives are highly educated and trained medical professionals who have studied and graduated from some of the most respected formal education programs in the country. They are able to be designated as Nurse Midwives only because they have successfully completed a rigorous national certification examination.

A Midwife Offers an Elevated Model of Care

Our midwives are specialists in women’s health. Alongside our physician experts and support team, they provide primary and reproductive care to women of all ages. Midwives have particular expertise in normal pregnancy, labor, and delivery. Scientific studies have shown that care under a midwife significantly decreases the risk of medical interventions, including cesarean delivery. Our midwives do an extraordinary job caring for the patients in our practice.

Midwives and Childbirth

At Delaware Valley OB/GYN, we recognize that childbirth is a natural phenomenon and that most pregnancies are healthy ones. There are some pregnancies that do need extra medical attention and care. Our midwives work collaboratively with our physicians to recognize when a patient needs that extra attention. When our physician must assume a lead role due to the degree of increased pregnancy risk status, our midwives continue to participate in physical care, counseling, guidance, teaching, and support of our patients. It is always our intention, for our midwives and physicians to apply their expertise and to work jointly when caring for women with special medical needs.

Midwives and Gynecology

Additionally, our Nurse Midwives are a great option as providers for gynecologic care. Here are five reasons to consider a Nurse Midwife for gynecologic care:

1. Midwives Have a More Holistic Approach to Healthcare
   In general, nurse-midwives tend to have more time to answer all your questions. They can help you learn about the physical and emotional changes you experience as you prepare for your expanding family or with your general care.For those who are expecting, births overseen by CNMs usually have less intervention – such as continuous electronic fetal monitoring, epidurals, and episiotomies – often with better outcomes for women and their babies. Studies have clearly shown that women using CNMs have much lower rates of cesareans.

2. Midwives Can Help with Family Planning 
   A CNM can be a great resource before you have children by assisting with family planning. CNMs also provide contraceptive counseling and services, including prescriptions for oral contraceptive pills, IUD insertions and removals, insertion and removal of hormone-releasing birth control implants.
3. Certified-Midwives Are Qualified to Care for Women Long-term
   This is just like an annual exam with a gynecologist. The midwife does a complete physical exam including a vaginal exam, takes a PAP smear, breast exam and will discuss relevant health topics with you such as family care and nutrition. Many women opt for a midwife because they feel their midwife is someone who is willing to invest personal time and attention in their needs. Certified midwives can also assist women as they enter menopause and face hormonal issues.
4. Certified Nurse-Midwives Are RNs, Have A Master’s and/or Doctoral Degree in Nursing, and National Certification and Licensure in the State in Which They Work
   This preparation qualifies them to perform examinations, order lab tests, prescribe medications, etc. So, pregnant or not, they are a great resource for overall family care. If a pregnancy occurs, you can rest assured they are trained to assist you in having the most healthy and happy pregnancy and birth that is possible. And, CNMs have relationships with physicians in case there is a high-risk situation.
5. They Offer Access to Additional Holistic Resources 
   Another great reason to become connected with a nurse-midwife is the opportunity to tap into their network. They are often entrenched in their communities, and can offer great recommendations on other natural, holistic providers. They regularly work with massage therapists, acupuncturists, doulas and yoga therapists. Don’t hesitate to ask for referrals whether you are expecting or not.

Midwife Appointments at DelVal OB/GYN

Giving birth is one of life’s most wonderful and amazing events. The entire team at Delaware Valley OB/GYN considers it a privilege to be entrusted with assisting women in having a healthy pregnancy, birth, and newborn. You can schedule an appointment with a midwife just like scheduling an appointment with a physician at our Practice HERE. And, our midwives participate in OB call for deliveries 24/7.

This is an added dimension of choice provided to you for convenience and satisfaction.