Menorrhagia

Area of Science:

• Gynecology
• Surgical Interventions
• Evidence-Based Medicine

Background:

• Menorrhagia, or heavy menstrual bleeding, significantly impacts women's quality of life and can lead to anemia.
• Potential causes include prostaglandin disorders, fibroids, adenomyosis, and intrauterine devices (IUDs).
• A significant proportion of hysterectomies for menorrhagia are performed on uteri without identifiable pathology.

Purpose of the Study:

• To systematically review and categorize the efficacy of surgical treatments for menorrhagia.
• To assess the effectiveness and safety of various surgical interventions for heavy menstrual bleeding.

Main Methods:

• A systematic overview of existing literature was conducted.
• Searches were performed in major databases including Medline, Embase, and The Cochrane Library up to February 2014.
• GRADE evaluations were performed for 30 PICO combinations.

Main Results:

• The review identified and evaluated 46 full publications, including newly added systematic reviews and RCTs.
• Efficacy data for dilatation and curettage, endometrial destruction (resection or ablation), and hysterectomy were analyzed.
• The study categorized interventions based on effectiveness and safety profiles.

Conclusions:

• The systematic overview provides a categorization of the efficacy of three key surgical interventions for menorrhagia.
• This information aids in understanding the effectiveness and safety of dilatation and curettage, endometrial destruction, and hysterectomy.