Menorrhagia

Abstract 

One in 20 women of reproductive age consults their general practitioner each year in the UK because of heavy menstrual bleeding. The impact on their social, professional and sexual life can be significant and, more than half will be referred to secondary care without any investigation or treatment being instituted. There are many causes for menorrhagia but, of those who undergo hysterectomy, more than half will be found to have a completely normal uterus. Hysterectomy has been a popular treatment for heavy periods, with one in five women in the UK having their uterus removed before the age of 60 years. New effective treatments – such as the Mirena intrauterine system and second generation endometrial ablation – should see rates of hysterectomy for the treatment of dysfunctional uterine bleeding fall.

Keywords: dysfunctional uterine bleeding, endometrial ablation, fibroids, heavy menstrual bleeding, hysterectomy, intrauterine system, uterine artery embolisation