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Abnormal Uterine Bleeding


There are many different causes of abnormal bleeding.

  • MDC -Menstrual Disorders Clinic UHCW
  • CAS – Clinical Assessment Service / Community Gynae Clinics (City of Coventry Health Centre)
  • Both clinics have facilities for ultrasound, so there is no need to arrange before referral
  • HMB – heavy menstrual bleeding
  • DUB – dysfunctional uterine bleeding
  • PCB – post coital bleeding
Heavy & Abnormal Uterine Bleeding Guidance (use link on right panel)

Uterine enlargement / pain       – page 1

Regular heavy bleeding            – page 2

Irregular heavy bleeding           – page 3

Post Coital Bleeding (updated) – page 3

*PCB needs a 2WW referral only of the cervix appears abnormal on examination (do not refer directly to colposcopy)

PCB is now to be referred to the MDC (Menstrual Disorders Clinic) or Community Consultant Clinic primarily for a TVS and examination of the cervix, as the majority of these would be symptomatic due to endometrial shedding or some other functional menstrual problem.

If a colposcopy is required a referral will be made from Secondary Care.

If the cervix appears suspicious on examination in Primary Care a 2WW referral should be made.

Post menopausal bleeding       – page 4

2 week wait referrals                 – see separate link

Mirena coil fitting

If your surgery does not offer a service for Mirena coil fitting, then the patient can make their own arrangements by phoning Integrated Sexual Health Services on 0300 020 0027.

Alternatively, where additional gynaecological factors need assessment, you can refer via NHS e-referral to “Community Assessment Service/ Community Gynaecology Clinic” at City of Coventry Health Centre.


It is important that healthcare professionals understand what matters most to each woman and support her personal priorities and choices.

Hysterectomy should be considered ONLY when:

  • Other treatment options have failed or are contradicted
  • There is a wish for amenorrhoea
  • The patient (who has been fully informed) requests it and no longer wishes to retain her uterus and fertility.


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