By Elizabeth Wilkerson -- Daily Staff Writer

WOODSTOCK — For many women, menstruation is a simple, if somewhat inconvenient, fact of life.

But, for the roughly 10 million women who experience heavy or prolonged menstrual bleeding each month, it's more than a period — it's a problem.

According to the National Women's Health Resource Center, as many as one in five women — approximately 10 million — in the U.S. have problem periods caused by heavy menstrual bleeding, a condition clinically referred to as menorrhagia. Other symptoms can include pain, fatigue, anxiety, nausea, sexual dysfunction and anemia.

Many women try to adapt to such periods, said Dr. Margaret Loewith, a local gynecologist. But, it's within "the last generation of women" that problem periods have become "unacceptable," she said, especially as more and more women have entered the workforce.

"I think there's less tolerance of it," said Loewith, who has been in private practice for 21 years.

But, she said, there is only one question a woman needs to ask herself when considering having something done: "Is my quality of life affected by the fact that I have periods that are heavier than I think they should be?"

Woodstock resident Donna Albright, 44, said she suffered from problem periods for more than a decade.

"I seemed to start having problems after my second son," and the tubal ligation that followed his birth, she said. "It got worse, and worse and worse."

During her periods, Albright said she experienced heavy bleeding and "a lot of pain." She stayed home much of the time while she was menstruating, she said, because of the pain, fatigue and possibility of embarrassing accidents.

"I would stay in bed a lot," she said. "It was just a mess. ... It just puts a damper on your life."

Traditional treatments for menorrhagia include hormone therapy and hysterectomy, a surgical procedure in which the uterus — and, in 50 percent of cases, the ovaries — is completely removed. Albright said one doctor suggested she have a hysterectomy, but she was reluctant to undergo the surgery.

After she moved to the area about two years ago, another doctor recommended she see Loewith, who soon suggested another procedure, Albright said.

Loewith said endometrial ablation, an outpatient procedure in which the lining of the uterus is permanently removed, is an "effective alternative" for women with problem periods. In 60 percent to 80 percent of cases, she said, the procedure eliminates the need for a hysterectomy.

Loewith said the preferred technique for endometrial ablation seems to be NovaSure, a procedure in which a slender wand is inserted into the uterus and a gold-plated, mesh triangle is expanded. The mesh conforms to the shape of the uterus, she said, and radio frequency energy, which is intended to permanently remove the lining of the uterus, is applied.

On average, the energy is applied for about 90 seconds, but Loewith said her shortest procedure took only 38 seconds and her longest only 127 seconds. Patients who undergo the procedure, which can be performed in a doctor's office or hospital, are typically "in and out in about two hours," Loewith said.

The procedure's overall cost is "remarkably less" than that of a hysterectomy, and the recovery time is significantly less, as well, she said.

"And the results have been, across the board, excellent," she said. She said she is unaware of any of her NovaSure patients who are now having periods.

Albright said she did experience some cramping immediately after she underwent the procedure in April 2007, but she had recovered by the following day. She is no longer menstruating, she said.

"Now, I can go and not worry about it," she said. She has told friends and family members about the procedure, she said, and would recommend it to anyone who is suffering symptoms similar to hers.

"This is what they need to do, really," Albright said. "I mean, I would have had it done 12 years ago if I'd known."

With any procedure, there is a risk of bleeding and infection, Loewith said, and there is a risk of "putting an instrument through the wall of the uterus." But those risks are extremely low with the NovaSure procedure, she said, and the overall risk level is "certainly lower than for a hysterectomy."

"When I came to the county and started seeing patients here, probably half of my patients had had hysterectomies," Loewith said. "I think in the valley it's a cultural phenomenon," and the procedure is "what a lot of women expect," she said.

Though ablations have become more common — in a given year, Loewith performs roughly 15 NovaSure procedures for every hysterectomy — the procedure is still not widely known in the area, she said.

Loewith said the procedure is for women who have finished having children, though it "isn't designed to be a contraceptive."

"The perfect patient is the woman who has got not-so-many years to go before menopause," she said, but "hysterectomy is probably not the best procedure for a 35-year-old."

"It's such a benign procedure," she said, and there is "no harm in trying" it before turning to a more invasive treatment for problem periods.

Though Albright said she was tempted "to chicken out" the night before the procedure, it has "made a world of difference" in her life.

"I think just getting there was the worst part," she said. "I am so glad I did it. It makes life a lot easier."

* Contact Elizabeth Wilkerson at ewilkerson@nvdaily.com