This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages without signing in

History of heavy menstrual bleeding

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • aspects to be covered in the history include:
    • nature of the bleeding
    • related symptoms that might suggest structural or histological abnormality e.g.such as intermenstrual or postcoital bleeding, pelvic pain and/or pressure symptoms
    • impact on quality of life and other factors that may determine treatment options (such as presence of comorbidity)

  • when diagnosing heavy menstrual bleeding (HMB), clinicians should take into account the range and natural variability in menstrual cycles and blood loss - the clinician should also discuss this variation with the woman

  • if the woman has a history of HMB without other related symptoms (such as persistent intermenstrual bleeding, pelvic pain and/or pressure symptoms, that might suggest uterine cavity abnormality, histological abnormality, adenomyosis or fibroid), consider pharmacological treatment without carrying out a physical examination (unless the treatment chosen is levonorgestrel-releasing intrauterine system [LNG IUS])

  • if the history suggests HMB with structural or histological abnormality, with symptoms such as intermenstrual or postcoital bleeding, pelvic pain and/or pressure symptoms, a physical examination and/or other investigations (such as ultrasound) should be performed

  • measuring menstrual blood loss is not routinely recommended for HMB

  • NICE emphasise that whether menstrual blood loss is a problem should be determined not by measuring blood loss but by the woman herself

Reference:

  1. NICE (March 2018). Heavy menstrual bleeding

Create an account to add page annotations

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.