Heavy Menstrual Bleeding in Korea

Gangnam, Seoul

Understanding and Treating Heavy Menstrual Bleeding in Korea

Heavy menstrual bleeding, medically known as menorrhagia or a type of Abnormal Uterine Bleeding (AUB), is more than just an inconvenience. It can significantly impact a woman's quality of life, leading to fatigue, anemia, and disruption of daily activities. South Korea's advanced medical system offers a thorough diagnostic approach and a wide range of effective treatments to address this common concern.

What is Considered Heavy Bleeding?

While "heavy" can be subjective, menorrhagia is generally characterized by:

  • Bleeding that soaks through one or more sanitary pads or tampons every hour for several consecutive hours.
  • Needing to use double sanitary protection to control your menstrual flow.
  • Needing to change protection during the night.
  • Passing blood clots larger than a quarter.
  • Bleeding for longer than seven days.
  • Symptoms of anemia, such as fatigue, shortness of breath, or dizziness.



Common Causes of Heavy Menstrual Bleeding in Korea

Korean gynecologists recognize that heavy bleeding can stem from various causes, which guide the diagnostic and treatment process:

  1. Hormonal Imbalances: Especially common in adolescents, perimenopausal women, or those with conditions like Polycystic Ovary Syndrome (PCOS), where irregular ovulation leads to an imbalance of estrogen and progesterone.
  2. Uterine Fibroids (자궁근종 - jagunguenjong): Non-cancerous growths in the uterus that can cause heavy or prolonged bleeding, often accompanied by pelvic pressure. (See our dedicated blog post on Uterine Fibroid Treatment in Korea).
  3. Uterine Polyps (자궁내막 용종 - jagungnaemak yongjong): Small, benign growths on the inner lining of the uterus that can cause irregular or heavy bleeding.
  4. Adenomyosis (자궁선근증 - jagungseonguenjeung): A condition where endometrial tissue grows into the muscular wall of the uterus, leading to heavy and painful periods.
  5. Endometrial Hyperplasia: An abnormal thickening of the uterine lining, which can be benign but may also be a precursor to uterine cancer, especially in postmenopausal women.
  6. Bleeding Disorders: Less common, but underlying systemic bleeding disorders (like Von Willebrand disease) can cause heavy periods.
  7. Thyroid Disorders: Both hyperthyroidism and hypothyroidism can disrupt menstrual cycles and lead to abnormal bleeding.
  8. IUDs (Intrauterine Devices): Non-hormonal (copper) IUDs can sometimes cause heavier periods, especially in the first few months after insertion.
  9. Medications: Certain medications, like blood thinners, can contribute to heavy bleeding.
  10. Complications of Pregnancy: Though not a menstrual period, heavy bleeding can be a sign of early pregnancy complications like miscarriage or ectopic pregnancy.
  11. Uterine or Cervical Cancer: While rare, especially in younger women, these serious conditions must be ruled out.


Diagnosis of Heavy Bleeding in Korea

Korean OB/GYN specialists use a comprehensive approach to pinpoint the cause of heavy bleeding:

  1. Detailed Medical History and Physical Exam: Your doctor will ask about your menstrual cycle, symptoms, family history, and perform a pelvic exam.
  2. Blood Tests:
  • Complete Blood Count (CBC): To check for anemia due to blood loss.
  • Hormone Levels: To assess thyroid function (TSH) and reproductive hormones (e.g., FSH, LH, Estradiol, Progesterone) if hormonal imbalance is suspected.
  • Coagulation Tests: If a bleeding disorder is suspected.
  1. Pelvic Ultrasound (초음파 - chopa): This is a primary diagnostic tool. Both transabdominal and transvaginal ultrasounds are used to visualize the uterus, ovaries, and endometrium (uterine lining) to detect fibroids, polyps, adenomyosis, or ovarian cysts. (See our dedicated blog post on Pelvic Ultrasound in Korea).
  2. Hysteroscopy (자궁경 검사 - jagunggyeong geomsa): If polyps or other abnormalities inside the uterine cavity are suspected, a thin, lighted scope is inserted through the cervix to directly visualize the uterine lining. This can be diagnostic and therapeutic (e.g., for polyp removal).
  3. Endometrial Biopsy (자궁내막 조직검사 - jagungnaemak jojikgeomsa): A small sample of the uterine lining is taken and sent for pathological examination, especially if endometrial hyperplasia or cancer is a concern.


Treatment Options for Heavy Bleeding in Korea

Treatment is tailored to the underlying cause, your age, overall health, and whether you desire future pregnancies. Korean clinics offer both medical and surgical interventions.

1. Medical Treatments (Non-Surgical):

These are often the first line of treatment.

  • Hormonal Contraception:
  • Combined Oral Contraceptives (OCPs): Can regulate cycles, reduce bleeding, and alleviate pain.
  • Progestin-Only Therapy: Can be given as pills, injections (e.g., Depo-Provera), or the Levonorgestrel-releasing Intrauterine System (Mirena IUD), which is highly effective in reducing heavy bleeding by thinning the uterine lining.
  • Tranexamic Acid: A non-hormonal medication taken during heavy bleeding days to reduce blood loss.
  • NSAIDs (Nonsteroidal Anti-inflammatory Drugs): Like ibuprofen, can help reduce blood loss and pain.
  • GnRH Agonists: (e.g., Lupron) Temporarily induce a menopause-like state to shrink fibroids and reduce bleeding. Usually used for a limited time.

2. Minimally Invasive Procedures:

  • Dilation and Curettage (D&C - 소파수술): A procedure to remove tissue from the uterine lining. Can be diagnostic and temporarily reduce bleeding. Often performed after a miscarriage or to sample the uterine lining.
  • Endometrial Ablation (자궁내막절제술): A procedure that destroys the lining of the uterus, significantly reducing or stopping menstrual bleeding. It's an excellent option for women who have completed childbearing and do not wish to have a hysterectomy. Korea offers various techniques (radiofrequency, thermal balloon, etc.). (See our dedicated blog post on Endometrial Ablation in Korea).
  • Uterine Fibroid Embolization (UFE / UAE - 자궁근종 색전술): An interventional radiology procedure that blocks blood flow to fibroids, causing them to shrink. (See our dedicated blog post on Uteroid Fibroid Treatment in Korea).
  • High-Intensity Focused Ultrasound (HIFU - 고강도 집속 초음파): A non-invasive procedure that uses focused ultrasound energy to destroy fibroid tissue, preserving the uterus. Korea is a leader in this technology. (See our dedicated blog post on Uterine Fibroid Treatment in Korea).

3. Surgical Treatments:

For severe cases, when other treatments fail, or for specific conditions like very large fibroids.

  • Myomectomy (자궁근종절제술): Surgical removal of fibroids while preserving the uterus. Can be performed via open surgery, laparoscopically, robotically, or hysteroscopically, depending on the fibroid's size and location.
  • Hysterectomy (자궁절제술): Surgical removal of the entire uterus. This is a definitive solution for heavy bleeding and is typically considered when other treatments have failed, or for women who do not desire future pregnancies. Can be done abdominally, vaginally, laparoscopically, or robotically.

4. Traditional Korean Medicine (TKM - Hanbang 한방):

While Western medicine is the primary approach for diagnosis and acute management, some women in Korea seek complementary TKM treatments for chronic heavy bleeding or to support overall reproductive health. TKM practitioners might use:

  • Herbal Medicine: Custom-prescribed herbal formulas aimed at regulating blood flow, strengthening the uterus, or addressing underlying "imbalances" (e.g., blood stagnation, qi deficiency).
  • Acupuncture: To help regulate menstrual cycles and reduce pain.


Cost of Heavy Bleeding Treatment in Korea

Costs vary significantly based on the diagnosis, chosen treatment, and your NHIS enrollment.

  • Consultation & Basic Diagnostics (with NHIS): Initial consultation and medically necessary tests like basic blood work and ultrasound are largely covered by NHIS, with patient co-pays of ₩5,000 - ₩50,000 KRW. Without NHIS, these can range from ₩50,000 - ₩300,000+ KRW.
  • Medications: With NHIS, prescriptions are heavily subsidized. Without NHIS, prices vary per medication.
  • Mirena IUD: The device itself is generally out-of-pocket (around ₩300,000 - ₩500,000 KRW for the device plus insertion fee).
  • Procedures & Surgeries (Out-of-Pocket Estimates for those without NHIS coverage):
  • Endometrial Ablation: Approximately ₩1,500,000 - ₩4,000,000 KRW (approx. $1,100 - $3,000 USD).
  • Myomectomy (Laparoscopic/Robotic): ₩5,000,000 - ₩15,000,000+ KRW (approx. $3,700 - $11,000+ USD).
  • Hysterectomy (Laparoscopic/Robotic): ₩8,000,000 - ₩20,000,000+ KRW (approx. $5,900 - $14,700+ USD).
  • HIFU (for fibroids): Can be significantly higher, ranging from ₩13,000,000 - ₩30,000,000 KRW (approx. $9,600 - $22,000 USD).
  • NHIS typically covers a significant portion of medically necessary surgical procedures for enrolled individuals.

Always obtain a detailed, itemized cost estimate from your chosen clinic or hospital before proceeding with any significant treatment.


Tips for Expats:

  • Be Specific about Symptoms: Clearly describe the volume, duration, and associated symptoms of your bleeding. A "bladder diary" can be very helpful.
  • Bring Medical History: Provide any previous diagnosis, test results, or treatment history (translated into English if possible).
  • Ask About All Options: Discuss all available medical, procedural, and surgical options, along with their pros, cons, recovery times, and impact on future fertility.
  • Discretion: Be assured that Korean medical professionals maintain high standards of privacy and professionalism.

Don't let heavy bleeding control your life. With excellent diagnostic capabilities and diverse treatment options, South Korea offers effective solutions to help you regain comfort and improve your well-being.

The female director personally provides care, listening to each patient's story.


01 - One-on-One Personalized Treatment
02 - Post-Treatment Management Syste

03 - Precise Diagnostic Program

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