Menorrhagia

This review is a pragmatic attempt to highlight recent research and background material in menorhagia. It should not be considered exhaustive, simply a way of reviewing some of the major developments and current thinking in the area.

Click here to see all the TRIP Evidence Reviews.

Evidence-Based Reports

• Progesterone IUD is effective for menorrhagia. POEMs, 2005
• Hysteroscopy or Ultrasound in menorrhagia? CATs - Birmingham Women's Hospital, 2004

Clinical Guidelines

• Heavy menstrual bleeding. NICE, 2007
• Menorrhagia. PRODIGY, 2005

Systematic Reviews

• Endometrial cryotherapy for menorrhagia. NICE, 2006
• Impedance-controlled bipolar radiofrequency ablation for menorrhagia. NICE, 2004
• Endometrial ablation techniques for chronic refractory menorrhagia. Medical Services Advisory Committee, 2005
• Endometrial destruction techniques for heavy menstrual bleeding. Cochrane Database Systematic Reviews. 2005
• Progesterone or progestogen-releasing intrauterine systems for heavy menstrual bleeding. Cochrane Database of Systematic Reviews, 2005
• Surgery versus medical therapy for heavy menstrual bleeding. Cochrane Database of Systematic Reviews, 2006

Recent articles in core journals

• Clinical outcomes and costs with the levonorgestrel-releasing intrauterine system or hysterectomy for treatment of menorrhagia: randomized trial 5-year follow-up. JAMA, 2004
• Randomised comparative trial of the levonorgestrel intrauterine system and mefenamic acid for the treatment of idiopathic menorrhagia: a multiple analysis using total menstrual fluid loss, menstrual blood loss and pictorial blood loss assessment charts. BJOG. 2005
• A randomised trial comparing the levonorgestrel intrauterine system and thermal balloon ablation for heavy menstrual bleeding. BJOG, 2006

eTextbooks

• Ganfyd
• eMedicine
• GP Notebook

Clinical queries

• For a women with fibroids, can she have the levonorgestrel-releasing intrauterine system for menorrhagia inserted safely? FFPRHC, 2005
• For a 58 year woman using the levonorgestrel-releasing intrauterine system for treatment of menorrhagia, when should the device be removed/replaced? FFPRHC, 2006
• What is the appropriate management for women with menorrhagia? NLH Q&A Service, 2006
• Is it safe to use tranexamic acid for menorrhagia when pt is on combined pill also? NLH Q&A Service, 2006
• Compared to other medical treatments how effective, if at all, are progestogens in treating menorrhagia, either alone or in combination? NLH Q&A Service, 2006

Patient information

• Menstruation - menorrhagia. Better Health Channel
• Recommended Medical Investigations and Treatments for Heavy Menstrual Bleeding – Information for Women. New Zealand Guidelines Group - Consumer Information
• Periods, heavy. NHS Direct Online
• Menorrhagia. Mayo Clinic