One in three women between the age of 40 and menopause suffer from heavy menstrual bleeding. Severe cramps, anemia and general weakness often result in an inability to function normally during her period. Physicians advise that such women consult a specialist to rule out the possibility of malignant disease. A hysterectomy is often the only solution recommended, yet less invasive treatments are available. Now the Patricia and Russell Fleischman Women's Health Center at Hadassah University Medical Center in Jerusalem's Ein Kerem is offering a new service - a free examination, consultation and description of the variety of treatments available. "Many women seek professional help only after years of suffering," says Dr. Yuval Lavi of the obstetrics and gynecology department at Hadassah University Medical Center on Mount Scopus. "They don't know there are treatments that can help solve the problem quickly and efficiently," he explains. Although many women feel a hysterectomy involves a loss of some femininity, about 6,000 of these operations are performed here annually. It is one of the most common gynecological procedures, and involves laparoscopic or general surgery, general anesthesia, a few days of hospitalization and several weeks of recovery at home. However, recently developed treatments often provide a feasible alternative. One of the newer treatments, thermal ablation, is a minimally invasive procedure that quickly and efficiently prevents the heavy bleeding without surgery. The treatment takes about eight minutes, and does not require general anesthesia or hospitalization. It has been proven throughout the world to be highly successful, and is included in the basket of health services. AVOID SELF-REFERRAL FOR VIRTUAL CARDIAC CT Upset by recent radio and newspaper ads encouraging smokers and other high-risk patients to undergo "virtual catheterization" at their own expense, the Israel Heart Society says it should be performed only if recommended by a cardiologist. Prof. Dan Tzivoni, president of the society and chief of cardiology at Jerusalem's Shaare Zedek Medical Center, and society secretary-general Dr. Michael Glickson, issued the statement. The non-invasive scan using computerized tomography costs thousands of shekels and is not in the basket of health services. The society says that while virtual catheterization is an "important test," its exactitude is not yet proven. The scan can also result in "side effects and possible harm," thus patients should not go for a virtual catheterization on their own initiative. "Self referral, instigated by commercial interests, could lead to additional and superfluous tests, and all the possible damage involved in them," the society concluded. Conventional catheterization involves making a small incision in the groin and pushing a thin catheter containing a tiny video camera up the femoral artery into the heart to see if the coronary arteries are dangerously constricted, posing the risk of a heart attack. Last July, the Health Ministry issued a warning against self-referral for such scans, which involve a dose of radiation and the injection of a contrast medium. DON'T BLAME PC FOR CARPAL TUNNEL PAIN Many people suffering from carpal tunnel syndrome in their wrists blame it on long hours of clicking a mouse and typing. Some have even sued their employers for this. But a special health report from Harvard Medical School refutes the assumption that computer use causes this painful syndrome. Instead, it is caused by compression of the median nerve in the wrist - a result of heredity, obesity, a fracture or even pregnancy. The 40-page report, called "Hands: Strategies for strong, pain-free hands," also explains the many causes of hand pain and describes the exercises, therapies and medications used to treat them. Carpal tunnel syndrome, a condition that affects around 3% of the population, occurs when one of the three major nerves that travel from the spinal cord to the hand becomes "pinched." It affects nearly twice as many women as men. A procedure to ease this nerve disorder is one of the most common surgeries done in the US, with more than 200,000 performed each year. Recent research has found that heavy computer use - up to seven hours a day - does not increase risk for carpal tunnel syndrome. However, improper computer use and other workplace conditions can contribute to a disorder known as repetitive stress injury. Carpal tunnel syndrome is in fact not a repetitive stress injury, though it is often described as one, says the Harvard report. The report also covers such topics as arthritis of the hand joints, Raynaud's syndrome, finger fractures, dislocation, accidental amputation, trigger finger, tennis elbow, lupus and gout. TV PRESENTS FALSE IMAGE OF COMA American soap operas paint an improbably rosy picture of coma patients' survival and recovery, according to a new study by University of Philadelphia researchers writing in the British Medical Journal. Tracking storylines containing coma patients over 10 years, researchers found that soap patients were far more likely to survive a coma than in real life, and much more likely to emerge unscathed. Only 8% of "patients" in TV serial dramas died during a coma, compared with more than half in real life - and all those who did survive recovered fully, while realistically just one in 10 would regain their previous health, usually after months of intense rehabilitation. Such unrealistic outcomes affect viewers' expectations when dealing with family members or partners in comas, or if recovering from comas themselves. Although families of coma patients are not often faced with decisions over life- sustaining treatment, such decisions are difficult and shrouded in uncertainty, say the authors. While soap storylines are not written to reflect real life, the media in general should balance stories of improbable survival and recovery with compelling and compassionate stories of characters who die in comfort and dignity.

Hysterectomy is not the only option for middle-aged women with heavy periods