New test for heavy menstrual bleeding

Updated NICE guidance has recommended the use of hysteroscopy for diagnosing and treating heavy menstrual bleeding, known as menorrhagia.

The guideline recommends that women with symptoms and/or risk factors for gynaecological diseases or conditions, such as persistent bleeding between periods, should be offered hysteroscopy. It is reported that menorrhagia affects around a quarter of women of a reproductive age.

Hysteroscopy uses a narrow telescope with a light and camera at the end, also called a hysteroscope, to examine the inside of the womb. It is estimated this recommendation will lead to a rise in the number of women having hysteroscopy from around 5,000 to around 15,000 in England each year.

Mark Baker, director of the centre for guidelines at NICE, said: “Heavy menstrual bleeding is a common condition that can have a major impact on a woman’s quality of life. Since we published our original guideline in 2007 there have been significant advances in diagnostic techniques which have been reflected in the new guideline.

“In many circumstances ultrasound has been replaced with hysteroscopy as a first line investigative test as it provides a more accurate diagnosis. This change should help ensure women with underlying endometrial diseases or conditions are more effectively diagnosed and can therefore receive better treatment. Not only this but the cost of additional hysteroscopy will be offset by savings from fewer ultrasound investigations and fewer appointments following the diagnostic test.”