From 1 April 2021, this website will not be updated.
For the latest local health and care information, visit www.nwlondonccg.nhs.uk
Brent, Central London, Ealing, Hammersmith and Fulham, Harrow, Hillingdon, Hounslow, and West London Clinical Commissioning Groups (CCGs) have merged as of 1 April 2021 to form North West London CCG. Brent, Central London, Ealing, Hammersmith and Fulham, Harrow, Hillingdon, Hounslow, and West London Clinical Commissioning Groups is transferring to the new CCG – North West London Clinical Commissioning Group on 1 April 2021. The new Clinical Commissioning Group will become the new data controller.
In March 2018 NICE published an update to their Heavy Menstrual Bleeding: Assessment and Management guideline. A summary of the revised is highlighted below:
Referral for hysterectomy should be considered only if the following three criteria are met:
1. There has been a prior unsuccessful trial with a levonorgestrel-releasing intrauterine system, unless medically contraindicated
2. At least two of the following treatments have failed, are not appropriate or are contraindicated in line with the NICE guidelines:
• Non-steroidal anti-inflammatory agents
• Tranexamic acid
• Combined oral contraceptives
• Oral norethisterone
• Injected long-acting progestogens
3a. Endometrial ablation has been considered
3b. Patient has fibroids >3cm or the uterus is bigger than a 10-week pregnancy.
Women who have contraindications or ethical reasons for not trying LNG-IUS must have tried two or more of the second line treatments and failed. These include:
• Three cycles of tranexamic acid or NSAID treatment
• Three cycles of alternative hormonal contraceptive treatment in line with NICE guidelines (NICE CG44)