Health care implications of dysfunctional uterine bleeding

Objective menorrhagia (measured menstrual blood loss of > 80 ml) affects approximately 10% of the population, while the subjective complaint of menorrhagia is experienced by almost a third of the female population of childbearing age. Consequently, large numbers of women consult their general practitioners annually and many are subsequently referred on for gynaecological opinion. Ineffective utilization of medical therapies may result in inappropriate referral and subsequently may result in operative intervention. The introduction of many minimally invasive techniques to manage menorrhagia has not brought about the expected reduction in surgical intervention rates but has merely increased the overall operative burden on the National Health Service (NHS). Recent advances in medical therapy may, for the first time, offer a rational and effective alternative to surgical therapy but long-term clinical and cost effectiveness studies are required. At present menorrhagia continues to be a major drain on health care resources.