Heavy menstrual bleeding

Menstrual health is an important part of a woman’s life course but poor diagnosis and suboptimal treatment of common menstrual health problems continue.

Heavy menstrual bleeding

Many women struggle to manage their menstrual health for various conditions including Heavy Menstrual Bleeding (HMB). HMB can often be a condition that is ignored, or it can be a sign of an underlying condition that women are uninformed about and for which women should be offered appropriate diagnosis and treatment.   

Debby Holloway, FRCN has recently published an article on the impact of heavy menstrual bleeding. The article looks at how investigations differ depending on the signs and symptoms and considers management options. See: Medscape UK. Heavy menstrual bleeding.

Menstrual Health Coalition

The Menstrual Health Coalition is a coalition of parliamentarians, patient and advocate groups, life sciences industry, leading clinicians and individuals who have come together to discuss and make recommendations around menstrual health.

The Coalition works to raise the profile of menstrual health on the political and policy agenda, to reduce the stigma around talking about periods, and campaign for change to help women adversely affected by their menstrual health.

The Menstrual Health Coalition (MHC, 2020) published the report ‘Heavy Menstrual Bleeding – breaking silence and stigma’. This publication is the result of an inquiry on heavy menstrual bleeding (HMB) which gathered data and input from a range of stakeholders, including Royal Colleges, patients, patient groups and leading clinicians.

It found that stigma around menstrual health is having a significant impact on access to care for women suffering with HMB. Of those who responded to the inquiry, the average rating for the prevalence of stigma around HMB was 8 out of 10 (10 being the highest level of stigma). Stigma is preventing women of all ages from learning about the symptoms of HMB and understanding what is normal for them during their menstruation, and therefore when to seek help.

According to the findings, stigma also results in women being reluctant to talk about this condition with friends, colleagues or healthcare professionals. This, compounded with a lack of awareness, makes it more difficult for women to talk about health issues and could lead to women being less cognisant of symptoms, which in turn delays access to appropriate diagnostic services and treatment.

The Coalition’s report has called on the Government, relevant NHS organisations and stakeholders to ensure that women suffering with HMB get the right support, advice and appropriate treatment for their symptoms.

See:

• Menstrual Health Coalition. Heavy Menstrual Bleeding – breaking silence and stigma
• NICE guideline. Heavy menstrual bleeding: assessment and management (NG88) (Published 2018, last updated 2020)
• NICE quality standard. Heavy menstrual bleeding (update)
• Royal College of General Practitioners. Heavy Menstrual Bleeding. A free half-hour course which aims to improve the management of heavy menstrual bleeding (HMB)

Decision support tool

This decision support tool from NHS England (2023) provides help and advice for the management of heavy periods.