NHS help for Heavy Periods

Fibroid Network

Nice Guideline HMB
The NHS NICE (National Institue for Clinical Excellence) Heavy Menstrual bleeding guideline (HMB) Guideline – CG44 was published in 2007. The HMB Patient Guide to Treating Heavy Periods is available for FREE download here:

CLICK HERE TO VIEW The Patients Guide to Treatments

You can read & search the FULL HMB Guideline HERE

CLICK HERE for the FREE DOWNLOAD of the full , Evidence based 2007 UK Heavy Menstrual Bleeding (HMB) GUIDELINE for Patients & NHS Healthcare Providers: with full research & evidence on treating Heavy Periods including recommended Drug Treatments & Surgery with or without Fibroids Published January 2007 . Please note that this Guideline is being reviewed with a current target date of March 2016, particularly in respect of medical Treatments for Fibroids.

HMB Guideline Updates:
The Guideline wishes practitioners & patients to be aware that ‘Oral progestogen (norethisterone)which was previously recommended , is not licensed for use as a contraceptive, but may affect a woman’s ability to become pregnant while it is being taken. This is one of a number of treatments , due for review. Please see website

Patient Feedback Post 2007 HMB Guideline

From a patients perspective, we would also want an urgent NHS review of all medical & surgical treatments, including Hormonal Contraceptives & Mirena , which are now being used as treatment for Menorrhagia & Fibroids. We have received Patient feedback, that Women with Fibroids are not being given full informed choice of treatments available , including Uterine Fibroid Embolisation & Myomectomy in situations where it is recommended in the guideline.

Women have told us that they are only being offered Medical treatments or Hysterectomy. They have also stated that they have not been given written information about their Menorrhagia (Heavy Periods) or Fibroids, and the full rage of options available, to assist in their decision making. They have also not been advised of the Risks & benefits of the Medical Treatments & Hormonal Contraceptives offered. And they have not been told that if they have relief from symptoms, using medical treatments, the relief only lasts as long as the medical treatment is being taken & the symptoms are likely to resume if medical treatment is discontinued.

We have also had feedback that even where further fertility is not desired by a woman, Doctors are not considering some patients desires , not to be given a premature surgical menopause by having a Hysterectomy (Womb Removal). Continue reading

Italian researchers have found a link between fibroids & diet

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An Fibroid Study in Italy found that fibroids were more common in women who ate beef and ham frequently, and less common in women who ate more green vegetables & fruit had a lower risk of fibroids. Abstract of the Medical Paper Objective: To analyze the relation between selected dietary indicators and the risk of uterine myomas. Methods: They used data from a case-control study on risk factors for uterine myomas conducted in Italy between 1986 and 1997. Cases included 843 women with uterine myomas whose clinical diagnoses dated back no more than 2 years. Controls were 1557 women younger than age 55 who had not had hysterectomies and were admitted for acute nongynecologic, nonhormonal, nonneoplastic conditions. Results: Women with uterine myomas reported more frequent consumption of beef, other red meat, and ham and less frequent consumption of green vegetables, fruit, and fish. The multivariate odds ratios in the upper tertile were 1.7 for beef and other red meat (95% confidence interval [CI] 1.4, 2.2), 1.3 for ham (95% CI 1.0, 1.6), 0.5 for green vegetables (95% CI 0.4, 0.6), and 0.8 for fruit consumption (95% CI 0.6, 1.0). Parazzini, MD Istituto di Ricerche Farmacologiche “Mario Negri” Francesca Chiaffarino ScD, Fabio Parazzini MD, Carlo La Vecchia MD, Liliane Chatenoud ScD, Elisabetta Di Cintio ScD and Silvia Marsico MD “Diet and uterine myomas” Istituto di Ricerche Farmacologiche “Mario Negri,” Milan; and the Prima Clinica Ostetrico Ginecologica and Istituto di Statistica Medica e Biometria, University of Milan, Milan, Italy Alcohol especially Beer is also a Risk Factor for Fibroids . This Study involved 22,000 women.

References

  • Chiaffarino F1, Parazzini F, La Vecchia C, Chatenoud L, Di Cintio E, Marsico S. Diet and uterine myomas. Obstet Gynecol. 1999 Sep;94(3):395-8. PMID: 10472866.

Use of medical, surgical and complementary treatments among women with fibroids

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Jacoby VL, Jacoby A, Learman LA, Schembri M, Gregorich SE, Jackson R, Kuppermann M

Eur. J. Obstet. Gynecol. Reprod. Biol. 2014 Nov;182:220-5

PMID: 25445104

Abstract

OBJECTIVE: To examine the use of medical management, uterus-preserving surgery (UPS), and complementary treatments among women with uterine fibroids.

STUDY DESIGN: Prospective cohort study of 933 premenopausal women ages 31-54 years with symptomatic fibroids who participated in the Study of Pelvic Problems, Hysterectomy, and Intervention Alternatives (SOPHIA) for an average of 4.3 years (SD 2.5 years). Incident use of fibroid treatments was determined through annual interviews. Linear regression models were used to compare changes in fibroid-related symptoms among women who underwent UPS versus those who did not undergo surgery.

RESULTS: Participants were racially and ethnically diverse, with a mean age of 43 years. During study follow-up, 531 participants (57%) did not undergo UPS or hysterectomy, 250 (27%) had at least one UPS, and 152 (16%) underwent hysterectomy. Complementary and alternative treatments were commonly used, including exercise (45%), diet (34%), herbs (37%), and acupuncture (16%): participants reported significant symptom improvement and few side effects with these interventions. In multivariable linear regression models, women who did not undergo surgery during the study reported improvement in dyspareunia (p<.001), pelvic pain (p<.001), and menstrual cramps (p<.001). However, women who underwent UPS reported greater overall resolution of "pelvic problems" compared with women who did not have surgical treatment (difference in change score 1.18 on a four-point Likert scale, p<.001).

CONCLUSION: UPS are effective treatments for women with fibroids, but many women use hormonal or complementary treatments and report significant symptom improvement without surgical intervention.