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Hysterectomy, Endometrial Ablation and Mirena® for Heavy Menstrual Bleeding: A Systematic Review of Clinical Effectiveness and Cost-Effectiveness Analysis

Hysterectomy, Endometrial Ablation and Mirena® for Heavy Menstrual Bleeding: A Systematic Review of Clinical Effectiveness and Cost-Effectiveness Analysis

Health Technology Assessment - NIHR Evaluation, Trials and Studies Coordinating Centre (UK)

Version: April 2011

Background

Heavy menstrual bleeding (HMB) is a common problem which affects approximately 1.5 million women in England and Wales. The condition causes 1 in 20 women of reproductive age to consult their general practitioners (GPs) and accounts for 20% of gynaecology outpatient referrals. HMB can cause significant distress to women by affecting their performance at work as well as their social activities, and leads to a measurable reduction in quality of life (QoL). Surgery has been traditionally used as the definitive treatment of HMB such that, in the past, by the age of 55 years one in five women in the UK had a hysterectomy, over half of which were for HMB.

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