management of heavy menstrual bleeding

Last edited 06/2018 and last reviewed 03/2020

Treatment of menorrhagia may be surgical or medical. Surgery is usually indicated in cases of proven pathology, for example, uterine fibroids. Non-hormonal and hormonal agents may be used when the cause is uncertain or the woman is keen to retain her fertility.

NICE suggest that, in cases of menorrhagia/heavy menstrual bleeding, pharmaceutical treatment should be considered where no structural or histological abnormality is present, or for fibroids less than 3 cm in diameter which are causing no distortion of the uterine cavity.


  1. NICE (March 2018). Heavy menstrual bleeding