CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Menorrhagia (heavy menstrual bleeding) - Management
Alarm symptoms
- Alarm symptoms or signs suggestive of gynaecological cancer, which include:
- Persistent intermenstrual or postcoital bleeding.
- An unexplained vulval lump or vulval bleeding due to ulceration.
- A palpable abdominal mass that is not obviously uterine fibroids.
- If there are clinical features of cervical cancer, an urgent referral should be made without the need for a smear test, and regardless of previous smear results.
- For further information on when to refer to a specialist when a gynaecological cancer is suspected, see the CKS topic on Gynaecological cancer - suspected.
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