Menorrhagia = regular excessive menses occurring over several cycles in an otherwise normal menstrual cycle.

It’s mainly subjective – what’s normal for one women may be excessive for another.

NICE suggests bringing a women’s quality of life into it – ie excessive menstrual bleeding which effects a women’s quality of life.

Objectively menorrhagia is defined as more than 80mls blood loss.


  • Intrauterine Levonorgestrel releasing device (Merena coil) – anticipated 12month use
  • Tranexamic acid or non-steroidals with Combined oral contraceptives
  • Noresthisterone (15mg) daily for days 5-26 of the cycle or injected long acting progesterogens