Heavy Menstrual Bleeding, Improving Knowledge, Improving Lives
Iatrogenic causes for Heavy Menstrual Bleeding



  • Abnormal uterine bleeding caused by medical interventions or devices (such as the Copper intrauterine device) or medicines that impact the endometrium, influence ovulation or interfere with clotting mechanisms1



  • Heavy menstrual bleeding, breakthrough bleeding, or unscheduled endometrial bleeding that is related with the use of hormonal contraceptives, copper intrauterine devices or other medications1,2



  • Temporal relationship between the treatment or medication and the onset of HMB
  • A thorough medical history and gynecological examination (including transvaginal ultrasound) should be conducted to rule out other causes of bleeding3



  • Carefully evaluate the clinical indication for the medication or device responsible, the presence of comorbidities, structural uterine changes and the need for contraception and/or fertility preservation3
  • Stopping treatment or finding an alternative should be considered3,4

Iatrogenic HMB Library

Find more information and download materials on iatrogenic in the teaching and resources library.


  1. Munro MG, et al. Int J Gynaecol Obstet 2011;113:3–13.
  2. Whitaker L & Critchley HO. Best Pract Res Clin Obstet Gynaecol 2016;34:54–65.
  3. Maas AH, et al. Maturitas 2015;82:355–9.
  4. Faculty of Sexual and Reproductive Healthcare. Clinical guidance: Problematic bleeding with hormonal contraception.

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