Heavy menstrual bleeding used to be defined as menstrual loss of 80mls or more, however a definition by the National institute of clinical excellence (NICE) has simplified the definition as menstrual loss that the woman herself finds unacceptably heavy and interferes with her physical and social quality of life. This is because with most scientific studies there was a big overlap between what science found acceptable and women found acceptable.
Having said that the average woman would have a “normal” period, which would last for between 4-8 days with a cycle that occurs every month with an interval of between 22-35days.
This however varies with age at the beginning and the end of reproductive life periods tend to be irregular. As women age also periods tend to become irregular and somewhat heavy before they eventually stop.
Vaginal bleeding is considered abnormal if there is bleeding outside the normal cycle in between periods also known as intermenstrual bleeding or if there is bleeding after intercourse. If these symptoms occur they need to be investigated
World wide up to 20% of women will suffer from heavy menstrual bleeding (HMB) at some point in their lives. It accounts for 12% of referrals to gynaecology outpatient departments.
Historically up to 60% of women would end up with a hysterectomy within 5 years of referral but there are now a number of effective alternative ways to manage HMB without recourse to hysterectomy.