Is heavy menstrual bleeding investigated and managed appropriately?

Heavy menstrual bleeding (HMB) accounts for approximately 20% of gynaecology referrals. The National Institute of Clinical Excellence (NICE) recommendations provide the framework for evidence-based management of HMB. Despite this, previous studies have highlighted significant variation in the investigation and management of HMB. This was an observational study of clinical practice performed by retrospective case note reviews of 43 women referred to the Royal Bolton NHS Foundation Trust with HMB between May and June 2011. The care that these women received was evaluated and compared with that currently recommended by clinical guidelines. The investigation and management of HMB in both primary and secondary care was variable, often failing to meet standards recommended by NICE. Greater awareness of NICE guidance may result in improved care. Educational sessions and information provision targeted at healthcare professionals who manage women with HMB, may be beneficial.