Heavy Menstrual Bleeding

Excerpt

Update Information: In March 2018 we updated and replaced this guideline with NICE guideline NG88 on heavy menstrual bleeding.

Heavy menstrual bleeding (HMB) has an adverse effect on the quality of life of many women. It is not a problem associated with significant mortality. Many women seek help from their general practitioners and it is a common reason for referral into secondary care.

In order for women to be treated successfully, it is essential that the underlying problem is understood by both the patient and the healthcare professional. This guideline provides background information as well as covering epidemiology, physiology, investigation and, ultimately, treatment. The aim is to consider the evidence and review it, taking into account both the woman's and the healthcare professional's viewpoints and interests. This is not always easy but it is anticipated that the information contained in the guideline will help women reach an informed and beneficial decision with their doctors. Once they have read the guideline, they will know what questions to ask and what the options available to them are. Constructive dialogue should allow patients to be able to trust the advice given by their practitioner as they will be confident that they have the latest information and will be able to use it to inform this decision-making process.

Clinical guidelines have been defined as systematically developed statements which assist clinicians and patients in making decisions about appropriate treatment for specific conditions. This guideline has been developed with the aim of providing guidance on HMB. The effectiveness of the various treatments as well as their risks and benefits are discussed in relation to their use in the treatment of HMB but the discussion cannot be extrapolated to the use of particular treatments to relieve other symptoms, such as hysterectomy for cancer or endometriosis. The implications of each treatment in relation to fertility are also clearly stated so that no woman will undergo treatment that renders her infertile unless this is her specific wish.