Mid-Life Gynecologic Problems

By Camilla C Hersh, MD

Virginia Women's Health Associates

. https://vawomenshealth.com/

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Mid-Life Gynecologic Problems

For many women in mid-life, a variety of gynecologic problems can interfere with our busy lives. Periods often become extremely heavy, and after testing there is often a problem that may require intervention or even surgery. The problems often include fibroids (more than 50 percent of women have at least a few fibroids), endometriosis, and ovarian cysts. Sometimes the doctor will suggest surgery, maybe even a hysterectomy for these problems. The season of childbearing may be coming to a close, but may still be a possibility.

Thankfully we are living in a time when there are many great choices for treatment for these women’s health issues. We have choices our mothers and our aunts would never have dreamed of.

There have been amazing advances in the treatment of gynecological conditions. There are new extremely low dose pills which can diminish menstrual flow. Several new outpatient techniques for endometrial ablation allow us to transform the uterine lining to a bland scar, to nearly eliminate periods altogether.

Happily, if surgery does become necessary, minimally invasive robotic laparoscopic surgery is becoming more available. In the past most surgery required a large open surgical procedure, with an abdominal scar and six to eight weeks of initial recovery followed by months of slow final recovery. Although some patients still require open surgery, this was a great advance for most women.

Then for many years gynecologic surgical procedures could be done laparoscopically, using a simple camera through the umbilicus and two or more tubes. This was another great advancement. Most patients were good candidates and could take advantage of these new techniques, but like everything else, even greater advances have been made.

In the past few years, da Vinci robotic assisted laparoscopy has been added to the most state-of-the-art operating rooms. With this technique a sophisticated 3-D camera is placed through a tiny incision near the umbilicus, and then place long slender instruments with tiny double wristed hand-like tips into the abdomen and pelvis.

This new technology allows the surgeon to magnify the inside of the body and operate with unprecedented delicacy and detail. Precision is greatly increased while the risk of complications is decreased. Most women go home the day of, or the day after surgery, can drive in a week, and go back to work in two weeks. When surgery is required, new techniques involve less pain, quicker recovery time, and a lower risk of scarring. This is not your mother’s surgery.