
We will work together to improve your symptoms
Irregular bleeding can mean different things to different people. Some patients may have cycles that do not come when they are expected with a typical 28-day cycle, and others may have expected timing, but the amount of bleeding is unpredictable. For some patients, both are the case. After taking a history evaluation about what is normal for you and what is concerning for you, we will work together to improve your symptoms. An evaluation with history, physical exam, lab studies, and ultrasound are common ways to evaluate the cause of your concern. Once we have a complete picture, we can collaborate to devise a treatment plan that works for you. Both hormonal and non-hormonal treatments are possible and treatment will be individualized.
Endometrial ablation
Endometrial ablation is an excellent non-hormonal treatment for heavy bleeding after an appropriate workup. This is an outpatient procedure that is incisionless. During this procedure, we look inside the uterus with a small camera to make sure there are no abnormalities. Samples are taken and sent to the pathologist to confirm all normal tissue is present. The internal lining of the uterus is safely burned so that it may not regenerate every month leading to a period. This procedure can eliminate your monthly cycle or if it remains, it will be significantly reduced in amount. An ultrasound is important in the pre-op evaluation for this procedure so we ensure a great outcome.
Hormonal Treatments
Hormonal treatments are another option for controlling bleeding. Hormonal treatment can be long-term or short-term depending on the symptoms and causes. Some patients prefer a non-surgical way of managing bleeding issues.
da Vinci Laparoscopic Surgery
Every patient desires a good surgical outcome and we offer many second opinions. In most cases, an open hysterectomy or sacrocolpopexy is a substandard procedure with increased blood loss, length of stay, recovery, pain, and complications. When you are considering options for surgery, please make sure you are comfortable with the treatment plan and care discussed.

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Meet The Team
Dr. Bertles is licensed by the Texas State Board of Medical Examiners and is board-certified by the American Board of Obstetrics and Gynecology. Amanda Smith, PA-C, spent the first 15 years of her career in primary care and is excited to join Progressive Women's Care and Dr. Bertles as she brings her primary care knowledge to women's health.


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