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Last Updated: Wednesday, 24 January 2007, 00:30 GMT
No hysterectomy for heavy periods
Woman in silhouette
Heavy periods can stop women leading a normal life
The government's health watchdog says too many women with heavy periods are "suffering in silence" because they fear they will need a hysterectomy.

NICE said heavy menstrual bleeding could have a huge impact on women's lives but drugs and minor surgery were effective treatments.

Hysterectomy should only be offered as "a last option" said the Institute.

One in four women experience heavy menstrual bleeding at some point but half do not seek help.

The condition is the leading cause of reduced quality of life among women of child-bearing age.

Endometriosis, fibroids and hormonal imbalance can all lead to heavy menstrual bleeding although there can often be no specific cause.

It is also the commonest reason for anaemia in the developed world.

Many women suffer in silence with this condition believing wrongly that they should put up with it or that they only treatment is a hysterectomy
Andrea Sutcliffe, deputy chief executive, NICE

In the early 1990s, it was estimated that at least 60% of women presenting with heavy menstrual bleeding would have a hysterectomy to treat the problem.

However, the number of hysterectomies done in 2002-03 for heavy menstrual bleeding had fallen to 8,332 from 23,056 a decade earlier.

But many women are still afraid to seek help because they don't want their womb removed and doctors may not be aware of all the treatment options available, experts warn.

Drug treatment

NICE recommend the first drug treatment choice should be a small medicated plastic device that sits in the womb and slowly releases progestogen, preventing the lining of the womb from growing quickly.

Other oral drug treatments are also available.

And the development of surgical options such as endometrial ablation, which uses heat or microwaves to destroy the lining of the womb, has rendered hysterectomy unnecessary in many cases.

Fibroid Network said they still receive phone calls from women who have been told they have to have a hysterectomy but want another option.

Professor Mary Ann Lumsden, chair of the NICE guideline group and consultant in gynaecology in Glasgow said it was an "incredibly important problem".

"It affects well over a million women each year and means that some women can't get out of the house one or two days a month.

"It does cause a lot of misery.

"Women need to know what is on offer so they can make an informed choice that is for them."

She added that she would encourage any woman who suffered from menstrual bleeding that interfered with their normal life to visit their GP.

Suffer in silence

Andrea Sutcliffe, deputy chief executive at NICE said: "Many women suffer in silence with this condition believing wrongly that they should put up with it or that the only treatment is a hysterectomy.

"I hope this guidelines will encourage people to come forward to seek help with the assurance that they will benefit from high-quality services."

Bridgette York, the founding director of Fibroid Network who was a member of the guideline group said she could not get information about her fibroids - a condition which can cause heavy menstrual bleeding - when she was diagnosed.

"This guideline educates doctors and patients. We hope that when women go to their doctors they ask for the whole range of treatment options.

"We have been contacted by women who are 19 years old and have been offered a hysterectomy even though they don't have a cancerous condition.

"In most cases women would want to preserve their future fertility. Women want womb repair not womb removal," she said.




SEE ALSO
'I had an 11lb fibroid removed'
24 Jan 07 |  Health
Menstrual problems
20 Mar 06 |  Medical notes
Womb ops higher in poorer women
14 May 02 |  Health
Many womb ops 'unnecessary'
20 Mar 02 |  Health

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