Menorrhagia (HMB - Heavy Menstrual Bleeding)

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.

>80%

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:

Once ‘bothersome bleeding’ has been identified, follow the HELP diagnostic pathway for HMB

^{*You may wish to consider other treatments after trial of pharmaceutical options as per NICE guidelines: NICE Heavy Menstrual Bleeding NG88, 2018.}

The HELP protocol has been adapted in the UK to reflect the 2018 updated NICE guidelines. The HELP group is an expert panel of physicians from 12 countries with a special interest in heavy menstrual bleeding (HMB), supported and funded by Bayer.

The interactive HELP treatment algorithm, including clinical considerations for all approved treatment options

The HELP protocol has been adapted in the UK to reflect the 2018 updated NICE guidelines.
 

The HELP group is an expert panel of physicians from 12 countries with a special interest in heavy menstrual bleeding (HMB), supported and funded by Bayer.

NICE recommends 52mg levonorgestrel (e.g Mirena

^®

) as a first-line pharmaceutical treatment for HMB with no identified pathology.

 

• Provides effective relief from idiopathic menorrhagia.
• Achieves mean menstrual blood loss reduction of up to 96% vs baseline, at 12 months.
• Reduced bleeding promotes the increase of blood haemoglobin levels in patients with menorrhagia.
• Improves quality of life as scored by the Menorrhagia Multi-Attribute Scale (MMAS) more than usual medical treatments (tranexamic acid, mefenamic acid, combined oestrogen-progestogen, progesterone alone or medroxyprogesterone acetate).
• Totally or occasionally absent menstruation has been associated with prolonged continuation with Mirena^® (Levonorgestrel).
• May effectively manage bleeding problems during the transition through menopause.
  
  Mirena^® Prescribing Information