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JAMA Clinical Guidelines Synopsis
December 19, 2019

Assessment and Management of Heavy Menstrual Bleeding

Author Affiliations
  • 1Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois
  • 2Department of Medicine, University of Chicago, Chicago, Illinois
JAMA. 2020;323(3):270-271. doi:10.1001/jama.2019.17383

HMB is a common but distressing condition with a lifetime prevalence of 30%1 that is defined largely by the patient’s perception, aided by clues such as soaking a pad or tampon more than every 2 hours during peak flow, large clots, and interference with daily activities. About 1 in 20 women aged 30 to 49 years will consult their primary care physician because of menstrual disorders, and they comprise 12% of referrals to gynecologists.2 Less than half of women who experience heavy bleeding seek medical help, and care is often suboptimal. Women with HMB have significantly reduced health-related quality of life scores compared with women with normal menstruation, stemming from irritation and inconvenience, associated pain, self-consciousness, and social embarrassment.3