Heavy menstrual bleeding

Introduction

HEAVY menstrual bleeding (HMB) is defined as menstrual blood loss greater than 80mL. There is much confusion about terminology to describe abnormal uterine bleeding, and recently a FIGO (International Federation of Gynecology and Obstetrics) 1 classification has been published. 

HMB affects about 20% of women in the reproductive years, causing individual health problems, loss of productivity and absenteeism. It is the commonest cause of iron deficiency in the Western world and of chronic illness in the developing world. 

HMB may present as a chronic problem with a history greater than six months or an acute problem where bleeding has increased recently or as a single event. In some women it may be a change in their normal pattern of bleeding. 

HMB may be related to anovulatory cycles, especially at extreme ends of the reproductive spectrum. In adolescence, in the first 2–3 years

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