Menorrhagia
Assessing and managing women with heavy menstrual bleeding
The definition of heavy menstrual bleeding (HMB) has changed – it is no longer solely defined by millilitres of blood loss per cycle but now includes the impact on a women’s physical, social and emotional quality of life.
of women say that HMB affects their relationship with their partner or their performance at work, and it affects attendance at school or work for 68% of sufferers.
As many as 1 in 3 women are expected to be negatively affected by HMB during their life but knowledge of the condition is poor. As such, many women are unaware that there are treatment options available for HMB – you can help her to speak up with three key questions:
See how these same three questions can help you to determine individualised treatment plans for your patients through these case studies
How much do you
Do you need to change your sanitary protection during the
night/wake upduring the night to change protection?During your heaviest days, did you ever have bleeding where you bleed
through a tamponor sanitary pad inunder 2 hours?
Does it affect you
Do you pass large
blood clotsduring your period?Have you ever felt
faint or breathlessduring your period?
Does your monthly bleeding affect your
Does you have to organise your
social activitiesaround your menstrual bleeding?Are you concerned about having
accidentsrelated to your bleeding?
Once ‘bothersome bleeding’ has been identified,
*You may wish to consider other treatments after trial of pharmaceutical options as per NICE guidelines: NICE Heavy Menstrual Bleeding NG88, 2018.
The HELP group is an expert panel of physicians from 12 countries with a special interest in heavy menstrual bleeding (HMB), supported by Bayer.
Download the interactive HELP treatment algorithm
The HELP group is an expert panel of physicians from 12 countries with a special interest in heavy menstrual bleeding (HMB), supported by Bayer. It includes clinical considerations for all approved treatment options.
NICE recommends Mirena® as a first-line pharmaceutical treatment for HMB with no identified pathology.
- Provides effective relief from idiopathic menorrhagia.
- Achieves menstrual blood loss reduction of up to 96%.
- Reduced bleeding promotes the increase of blood haemoglobin levels.
- Improves quality of life more than usual medical treatments (tranexamic acid, mefenamic acid, combined oestrogen-progestogen or progesterone alone).
- Totally or occasionally absent menstruation has been associated with prolonged continuation with Mirena®.
- May effectively manage bleeding problems during the transition through menopause.
Prescribing Information: Mirena® (52 mg intrauterine delivery system Levonorgestrel)
PP-MIR-IE-0074-1 | January 2026