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Menorrhagia (heavy menstrual bleeding) - Management
Basis for recommendation
These recommendations are consistent with clinical guidelines on Heavy menstrual bleeding, published by the National Institute for Health and Clinical Excellence [National Collaborating Centre for Women's and Children's Health, 2007].
- Although there is evidence from diagnostic studies to support objective measurements to determine menstrual blood loss, this is generally felt to be impractical in most clinical situations and is unlikely to guide clinical management.
- Direct objective measurement of menstrual blood loss includes the alkaline haematin technique.
- The pictorial blood loss assessment chart is an indirect measure.
- Results from epidemiological studies have found that:
- Thyroid disease is not associated with menstrual disorders and therefore should not be routinely tested for.
- Coagulation disorders, such as von Willebrand disease, are an identifiable risk factor in women who have experienced heavy bleeding since the menarche.
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