New “Heavy Menstrual Bleeding Clinical Care Standard” and resources released

13 December 2017

Heavy menstrual bleeding is a common problem affecting one in four women of reproductive age, having a significant impact on their physical, emotional, social and material quality of life. Around 50% of women referred to secondary care for heavy menstrual bleeding experience severe or very severe pain, even when they do not have any uterine pathology. Disabling pain is often the reason women seek medical help, and for many it is after years of suffering before seeking treatment.

The Australian Commission on Safety and Quality in Health Care has developed, in collaboration with women’s health experts and consumers, the Heavy Menstrual Bleeding Clinical Care Standard. The development of the Standard was a recommendation of the first Australian Atlas of Healthcare Variation.

- There are many causes of heavy menstrual bleeding, but in about half of cases no cause can be identified

- It may be the result of a structural abnormality such as fibroids — non-cancerous growths of muscle tissue that form within the walls of the uterus

- Another possible cause is a disorder in the way blood-flow is regulated in the lining of the uterus

- The timing of ultrasounds in screening for heavy menstrual bleeding is crucial to get an accurate diagnosis

- Scans should be done five to ten days from the first day of a woman's period. This is when the lining of the uterus is thinnest and the reading will be the most accurate

The range of management options for heavy menstrual bleeding has expanded and improved in the past 30 years, when rates of hysterectomy for menstrual disorders were first observed to be relatively high. While hysterectomy remains an option and stops menstrual bleeding, it is a major surgical procedure and is not recommended as a first-line treatment under the new guidelines. Studies show Australia has one of the highest reported rates of hysterectomy in the OECD, with marked differences between regional and metropolitan areas.

The goal of the Heavy Menstrual Bleeding Clinical Care Standard is to ensure that women with heavy menstrual bleeding are offered easy to understand information about the risks and benefits of the various treatments, including the least invasive and most effective treatment appropriate to their clinical needs. It's hoped that helping women to make informed decisions and improving access to less invasive treatments may help some avoid the need for a hysterectomy

Download the Clinical Care Standard and resources

Find heavy menstrual bleeding resources on CKN