Feature Article

Heavy menstrual loss: Part 2. Management options

Vivienne M O’Connor



Heavy menstrual loss (menorrhagia) may be managed by observation, medical treatment or surgery. Hysterectomy can now be reserved as a second line option for many women – particularly those with dysfunctional uterine bleeding, for which there are effective hormonal and nonhormonal treatments.

Key Points

  • A complaint of heavy menstrual loss needs careful evaluation to determine its significance and possible underlying cause.
  • Some women have significant pelvic pathology as the cause and have little alternative to hysterectomy.
  • Many women have dysfunctional uterine bleeding. The medical and surgical options should be discussed with the benefits and risks for the individual woman.
  • The increasing number of medical options will reduce the need for major surgery in most women.