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  • This publication is provided for historical reference only and the information may be out of date.

This publication is provided for historical reference only and the information may be out of date.

Cover of Heavy Menstrual Bleeding

Heavy Menstrual Bleeding

NICE Clinical Guidelines, No. 44


London: RCOG Press; .
ISBN-13: 978-1-904752-35-6

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.


While every effort has been made to ensure the accuracy of the information contained within this publication, the publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check current indications and accuracy by consulting other pharmaceutical literature and following the guidelines laid down by the manufacturers of specific products and the relevant authorities in the country in which they are practising.

Copyright © 2007, National Collaborating Centre for Women's and Children's Health.

No part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK []. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.

The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore for general use.

Bookshelf ID: NBK56536PMID: 21938862


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