An Update on the Management of Heavy Menstrual Bleeding

Abstract

Heavy menstrual bleeding is a common problem in reproductive-aged women. It impairs the quality of life and is a common cause of anaemia. Pharmaceutical interventions continue to be first-line treatment, but when these fail it is usual to offer surgical options. In the early 1990s, at least 60% of women presenting with heavy menstrual bleeding would have a hysterectomy as the treatment of choice. Since then, newer therapeutic modalities such as the levonorgestrel intra-uterine device and endometrial ablation techniques have become available. In this article, we provide an overview of the diagnostic and therapeutic options and review the efficacy and acceptability of the pharmaceutical and surgical treatments that are available worldwide and locally.