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EasyObstetrics & GynaecologyHeavy Menstrual Bleeding (HMB)mrcgp aktukmlapaneprescribing safety assessment

A 34-year-old woman presents with heavy menstrual bleeding (HMB). Her periods last 7-8 days and she changes pads every 1-2 hours on the heaviest days, passing clots. She is otherwise well and examination is normal. FBC is normal. She does not desire contraception currently. According to NICE NG88 (Heavy Menstrual Bleeding), what is the recommended first-line pharmacological treatment, assuming no fibroids >3cm or suspected major pathology?

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