Treatment of menorrhagia before hysterectomy in a district general hospital. A retrospective review.

Between March 1996 and March 1998 236 women had a hysterectomy at Tameside District General Hospital. Of these, women, the indication in 132 was idiopathic menorrhagia and their treatments before hysterectomy were reviewed. It was found that luteal phase progestogens were the drug treatment of choice for menorrhagia by the general practitioners (GPs) and hospital doctors (46% and 40.5%, respectively). Fifty-two (39%) of the women had no medical treatment before hysterectomy while 38 (29%) had only one type of drug treatment. The decision to perform a hysterectomy was taken at the first clinic visit in 40 (30%) of the women and in 77 (58%) of them by the second visit. Transcervical resection of the endometrium (TCRE) was tried in 11% of the women, while none had the levonorgestrel impregnated intrauterine system (Mirena IUS) fitted. Objective assessment of menstrual loss was not performed before treatment. Our data suggest an early recourse to hysterectomy in the treatment of idiopathic menorrhagia and the hypothesis that hysterectomy follows failure of appropriate medical and alternative treatment of menorrhagia was not confirmed.