The results of a survey of 250 GPs indicates that low awareness of the NICE guidance on Heavy Menstrual Bleeding (HMB) may significantly affect their implementation across the UK. Results from the survey show that as many as seven in 10 GPs are either unaware that the guidelines exist, or are unfamiliar with the details.

HMB affects one in five women of reproductive age and is defined as excessive menstrual blood loss which interferes with the woman's physical, emotional, social and material quality of life, and can occur alone or in combination with other symptoms.

For women who are suitable for either hormonal or non-hormonal interventions, the recommended first-line treatment for HMB is the levonorgestrel-releasing intrauterine system (LNG-IUS 20mcg/day). However, results from the survey indicate that eight in 10 (83%) GPs may be unaware of this recommendation.

The survey found that only 3% of GPs routinely prescribe the LNG-IUS 20mcg/day as a first-line treatment. The most frequently-prescribed first-line treatments were tranexamic acid (60%) and non-steroidal anti-inflammatory drugs (17%), in line with GPs’ perceptions of NICE recommendations.

“HMB is a common condition that can have a profound impact on patients’ lives, so it is important that the most effective treatment is given as early as possible,” said Professor Janesh Gupta, Professor of Obstetrics and Gynaecology at University of Birmingham, Birmingham Women’s Hospital. “The Department of Health has set Quality Standards on HMB to help improve diagnosis, treatment and outcomes for women suffering from this condition – but an important part of this are awareness and implementation of the NICE treatment guidelines.”

Aside from low awareness, the survey reveals that nearly one in five (19%) GPs believe that the LNG-IUS 20mcg/day is unsuitable for younger women or those without children, yet research confirms that the IUS may be appropriate for all women of reproductive age, and can be equally suitable for women that have and haven’t had children.