NICE Guidelines: Hysteroscopy in HMB

Plain-Language Summary
The updated UK NICE guidelines recommend hysteroscopy as the preferred first-line investigation for heavy menstrual bleeding (HMB) when pathology is suspected. This represents a significant shift away from blind biopsy and ultrasound alone.

Key Takeaways:

• Hysteroscopy is more accurate than ultrasound for endometrial pathology.

• Blind biopsy should no longer be offered for HMB evaluation.

• Wider adoption of outpatient hysteroscopy will require resource investment and training.

Citation:
Ramshaw N, Narayansingh G. The implications of hysteroscopy in the updated guidelines on heavy menstrual bleeding from the UK National Institute for Health and Care Excellence (NICE). Case Rep Womens Health. 2019;22:e00117. doi:10.1016/j.crwh.2019.e00117