What is a diagnostic hysteroscopy for heavy periods?
Heavy periods (menorrhagia), is when a woman loses an excessive amount of blood during consecutive periods. Heavy bleeding does not necessarily mean there is anything seriously wrong, but it can affect a patient physically, emotionally and socially, and can cause disruption to everyday life.
A hysteroscopy is a procedure used to examine the inside of the womb (uterus). It is carried out using a narrow telescope with a light and camera at the end (hysteroscope). The hysteroscope is passed into the patient’s womb through their vagina and entrance to the womb (cervix), which means no cuts need to be made in the patient’s skin.
Diagnostic hysteroscopy as first-line diagnostic tool for identifying structural abnormalities related to heavy periods is not usually funded by the patient’s local NHS commissioning organisation unless ultrasound results are inconclusive. This is because national guidance recommends that:
- Ultrasound should be the first option to identify any abnormalities
Hysteroscopy procedure should only be used when ultrasound results are inconclusive, for example, to determine the exact location of a growths in the womb (fibroids) or the exact nature of any abnormality
- If imaging shows the presence of growths in the womb (fibroids) then appropriate treatment should be planned based on size, number and location of the fibroids
- Scanning with saline solution inserted into the womb (saline infusion sonography) should not be used as a first-line diagnostic tool
- Magnetic resonance imaging (MRI) should not be used as a first-line diagnostic tool.
The clinician in charge of the care of the patient’s specific condition, usually a hospital doctor, can assist the application, if there is exceptional clinical need for the treatment to be funded. The patient’s clinician must evidence clinical exceptionality and must be supported by the patient’s local NHS commissioning organisation.
See separate leaflet for more information on Individual Funding Requests (IFRs).
Advice and further guidance:
- For more information, read the ‘heavy menstrual bleeding (menorrhagia) decision aid’ or search ‘heavy period’ at www.nhs.uk
- Choosing Wisely UK is part of a global initiative aimed at improving conversations between patients and their doctors and nurses.
Treatment policy for patients covered by NHS Birmingham and Solihull CCG