Assessing and managing women with heavy menstrual bleeding
The definition of heavy menstrual bleeding (HMB) has changed – it is no longer solely defined by millilitres of blood loss per cycle but now includes the impact on a women’s physical, social and emotional quality of life.1
Once ‘bothersome bleeding’ has been identified, follow the HELP diagnostic pathway for HMB
*You may wish to consider other treatments after trial of pharmaceutical options as per NICE guidelines: NICE Heavy Menstrual Bleeding NG88, 2018.
The HELP protocol has been adapted in the UK to reflect the 2018 updated NICE guidelines. The HELP group is an expert panel of physicians from 12 countries with a special interest in heavy menstrual bleeding (HMB), supported and funded by Bayer.
The interactive HELP treatment algorithm, including clinical considerations for all approved treatment options
The HELP protocol has been adapted in the UK to reflect the 2018 updated NICE guidelines.
The HELP group is an expert panel of physicians from 12 countries with a special interest in heavy menstrual bleeding (HMB), supported and funded by Bayer.
NICE recommends Mirena® (52mg levonorgestrel) as a first-line pharmaceutical treatment for HMB with no identified pathology.1
- Provides effective relief from idiopathic menorrhagia.2
- Achieves mean menstrual blood loss reduction of up to 96% at 12 months.3
- Reduced bleeding promotes the increase of blood haemoglobin levels in patients with menorrhagia.2
- Improves quality of life as scored by the Menorrhagia Multi-Attribute Scale (MMAS) more than usual medical treatments (tanexamic acid, mefenamic acid, combined oestrogen-progestogen, progesterone alone, norethiderone, or medroxy-progesterone acetate).4
- Totally or occasionally absent menstruation has been associated with prolonged continuation with Mirena® (Levonorgestrel).5
- May effectively manage bleeding problems during the transition through menopause.6
- NICE clinical guidance NG88. Heavy menstrual bleeding: assessment and management, March 2018. Available at: https://www.nice.org.uk/guidance/ng88. Last accessed: June 2020. Return to content
- Bayer PLC. Mirena® Summary of Product Characteristics, 2020. Return to content
- Stewart A, et al. Br J Obs Gyn 2001;108:74–86. Return to content
- Gupta J, et al. N Engl J Med 2013;368:128–137. Return to content
- Backman T, et al. Br J Obs Gyn 2000;107:335–339. Return to content
- Depypere H and Inki P. Climacteric 2015;18:1–13. Return to content
Heavy Menstrual Bleeding (HMB): evidence-based learning for best practice.
A 30-minute, scientific e-learning course developed by the HELP expert panel of independent physicians*. Three case-based modules cover the diagnostic pathway and treatment algorithm for HMB to help you to counsel your patients effectively.
*The formation of the HELP expert panel and its ongoing work is supported by Bayer AG.