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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

NICE Guideline on heavy menstrual bleeding

The National Institute of Health and Clinical Excellence (NICE) has published a clinical guideline on heavy menstrual bleeding.

The Quick Reference Guide provides a clinical definition of heavy menstrual bleeding as covered by the guideline and a care pathway for individuals presenting with heavy menstrual bleeding.

The guideline also details the place in therapy for several pharmacological interventions including:

  • Levonorgestrel-releasing intrauterine system (First Line)
  • Tranexamic acid (Second Line)
  • Non-steroidal anti-inflammatory drugs (Second Line)
  • Combined oral contraceptives (Second Line)
  • Oral and Injected progestogen only contraceptives (Third Line)

Additionally, the guideline provides referral criteria for procedures such as endometrial ablation and hysterectomy.

Action: All clinicians and healthcare professionals who provide care to women presenting with heavy menstrual bleeding will find this guideline a useful reference and evidence summary.

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