Heavy Menstrual Bleeding Clinical Care Standard
The Heavy Menstrual Bleeding Clinical Care Standard (2024) aims to improve the quality of care for women with heavy menstrual bleeding and ensure that they can make an informed choice from the range of treatments suitable to their individual situation, including less invasive options where appropriate.
Download the updated Standard
The goal of the Heavy Menstrual Bleeding Clinical Care Standard is to ensure that women with heavy menstrual bleeding are offered the least invasive and most effective treatment appropriate to their clinical needs and preferences, and that they can make an informed choice from the range of treatments suitable to their individual situation.
The Standard was first published in 2017 and was revised in 2024 following a review of current evidence and consultation with clinical experts and key stakeholders.
Women's health: Heavy Menstrual Bleeding launch
The revised Standard was launched alongside the Women’s Health Focus Report on 13 June 2024. Together, these resources highlight areas for improvement in the care of heavy menstrual bleeding.
Find out more on the Women’s Health Hub - Heavy Menstrual Bleeding, including a Highlights Report, an address by the Hon Ged Kearney MP, Assistant Minister for Health and Aged Care, an overview of the new resources from Clinical Director, Associate Professor Liz Marles, and a consumer story.
Contents of the Standard and resources
The Heavy Menstrual Bleeding Clinical Care Standard contains:
- Eight quality statements describing safe and appropriate care
- A set of indicators to support monitoring and quality improvement.
View the complete list of implementation resources or see our targeted information and resources for consumers, clinicians, healthcare services and Primary Health Networks.
What changes have been made in the updated Standard?
The Standard has been updated to ensure the quality statements, explanatory information, and indicators align with the current evidence base and practice. While there has been no major change to recommended care for heavy menstrual bleeding, key updates to the Standard include:
- Increased emphasis on informed choice and shared decision making
- Inclusion of additional information about relevant tests, investigations and treatment options including uterine artery embolisation
- Addition of cultural safety and equity considerations
- Renaming Quality Statement 3 'Initiating Medical Management' and clarifying its focus on ensuring women are offered oral treatment for symptom relief at first presentation when appropriate.
- Amendments to the indicators, including new, retired, and changed indicators.
Further information on changes can be found on page 4 of the Standard.
Communication resources
Show your support for the updated Heavy Menstrual Bleeding Clinical Care Standard by sharing our resources on your website, social networks or within your health service organisation.
A communications kit with newsletter copy and social media graphics is available to help you share and promote the Standard within your networks.
Background
The Heavy Menstrual Bleeding Clinical Care Standard was first released in 2017 in response to the Atlas of Healthcare Variation series which found substantial variation in the rates of hysterectomy and endometrial ablation across Australia3,4, with Australian women undergoing hysterectomy at a higher rate than women in comparable Organisation for Economic Co-operation and Development (OECD) countries.5
The Women’s Health Focus Report 2024 examines trends in these procedures since the second Atlas in 2017. The Report shows:
- A decrease in hysterectomy rates of 20% nationally between 2014–15 and 2021–22.
- An increase in endometrial ablation hospitalisation rates of 10% nationally between 2013–16 and 2019–22.
Despite these improvements, variation remains. Rates of hysterectomy remain high by international standards, and are higher in regional areas compared to major cities and remote areas.
While the reasons for this variation are not fully understood, it is evident that access to, and uptake of, appropriate care is influenced by several factors. These include low patient awareness of suitable options; treatment costs to patients; limited availability of services; and limited numbers of clinicians with the knowledge, skills and equipment, or willingness to deliver services such as intrauterine device (IUD) insertion6,7, endometrial ablation or uterine artery embolisation. Women living in rural and remote Australia face additional challenges when it comes to accessing investigations and services such as ultrasound, IUD insertion and appropriate specialist medical care.
Read more about the scope and goal of this standard or see further background in the full Standard.
Consultation and endorsement
The Standard was reviewed in consultation with a topic working group of clinicians, researchers and consumers. A targeted consultation process was conducted with key stakeholders.
The Standard has been endorsed by 21 key organisations.
Evidence base
Further information is available on the evidence sources which underpin the Heavy Menstrual Bleeding Clinical Care Standard (2024).
Contact us
If you have questions about this clinical care standard, please email ccs@safetyandquality.gov.au.
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