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NICE Guidance
Conditions and diseases
Gynaecological conditions
Heavy menstrual bleeding
Heavy menstrual bleeding: assessment and management
Clinical guideline [CG44]
Published date:
January 2007
Last updated:
August 2016
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Measuring menstrual blood loss either directly (alkaline haematin) or indirectly ('Pictorial blood loss assessment chart') is not routinely recommended for HMB. Whether menstrual blood loss is a problem should be determined not by measuring blood loss but by the woman herself. [2007]
Do not do
December 2016
Unclassified
A serum ferritin test should not routinely be carried out on women with HMB. [2007]
Do not do
December 2016
Unclassified
Female hormone testing should not be carried out on women with HMB. [2007]
Do not do
December 2016
Unclassified
Saline infusion sonography should not be used as a first-line diagnostic tool.
Do not do
December 2016
Unclassified
Magnetic resonance imaging (MRI) should not be used as a first-line diagnostic tool. [2007]
Do not do
December 2016
Unclassified
Dilatation and curettage alone should not be used as a diagnostic tool. [2007]
Do not do
December 2016
Unclassified
Use of NSAIDs and/or tranexamic acid should be stopped if it does not improve symptoms within 3 menstrual cycles. [2007]
Do not do
December 2016
Unclassified
Danazol should not be used routinely for the treatment of HMB. [2007]
Do not do
December 2016
Unclassified
Oral progestogens given during the luteal phase only should not be used for the treatment of HMB. [2007]
Do not do
December 2016
Unclassified
Etamsylate should not be used for the treatment of HMB. [2007]
Do not do
December 2016
Unclassified
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