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Publication Date



These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly, these guidelines should guide care with the understanding that departures from them may be required at times.

Objective of the Care Process Model

1. Management of heavy menstrual bleeding potentially mitigating the need for hormonal medications for menstruating females 12 years and older.

2. Help to identify those patients with heavy menstrual bleeding possibly due to an undiagnosed bleeding disorder needing further subspecialty care.

Target Users

Emergency Department; Urgent Care Center; Inpatient Units; Teen Clinic; PCC; Gynecological consultants; Adolescent medicine consultants; House Staff

Clinical Questions Care Process Model

1) In adolescents > 12 years old who present with heavy menstruation is non-hormonal versus hormonal medication treatment better in the resolution of acute bleeding?

2) In adolescent patients with heavy menstruation is oral vs. intravenous tranexamic acid better in the resolution of acute bleeding?

3) What is the recommended dose for hormonal treatment of pre-teen or adolescent patients with heavy menstruation?

4) In preteen or adolescent patients with heavy menstrual bleeding, does ultrasound versus no ultrasound result in improved patient diagnosis and outcomes?



Heavy Menstrual Bleeding Emergency Department/Urgent Care

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Pediatrics Commons



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