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Hysterectomy or Endometrial AbLation Trial for Heavy menstrual bleeding

A multicentre randomised controlled trial comparing laparoscopic supra-cervical hysterectomy with second generation endometrial ablation for the treatment of heavy menstrual bleeding.


Heavy menstrual bleeding (HMB) is a common problem affecting approximately 1.5 million women in England and Wales with a major impact on their physical, emotional, social and material quality of life. It is the fourth most common reason why women attend gynaecology outpatient clinics and accounts for 20% of all gynaecology outpatient referrals. Initial treatment in primary care is medical - either by means of oral medication or the levonorgestrel-intra uterine system (Mirena®).  If medical treatment fails then surgical treatment can be offered, either endometrial ablation (EA) which destroys the lining of the cavity of the uterus (endometrium), or conventional hysterectomy i.e. surgical removal of the uterus. However, neither medical treatment nor conservative surgery result in complete resolution of symptoms and up to 59% of those on oral drugs and 13.5% of those using the levonorgestrel-intra uterine system (Mirena®) require surgery within two years, while 19% of women treated by EA need a hysterectomy for relief of their symptoms.

This trial aims to address the question 'Is laparoscopic supracervical hysterectomy (LASH) superior to second generation endometrial ablation (EA) for the treatment of heavy menstrual bleeding (HMB) in terms of clinical and cost effectiveness?'. Women < 50 years of age, with heavy menstrual bleeding (HMB), in whom medical treatment has failed and who are eligible for endometrial ablation will be considered for entry to the trial. We aim to recruit women from approximately 25 active secondary care centers in the UK NHS who carry out both surgical procedures.

This project is funded by the National Institute for Health Research Health Technology Assessment Programme (project number 12/35/23).  The views and opinions expressed herein are those of the authors and do not necessarily reflect those of the HTA programme, NIHR or Department of Health.

General Data Protection Regulation (GDPR) 
Participant Information

University of Aberdeen/NHS Grampian is the sponsor for this study based in the United Kingdom. We will be using information from you and your medical records in order to undertake this study and will act as the data controller for this study. This means that we are responsible for looking after your information and using it properly. University of Aberdeen/NHS Grampian will keep identifiable information about you at least 10 years after the study has finished. 

Your rights to access, change or move your information are limited, as we need to manage your information in specific ways in order for the research to be reliable and accurate. If you withdraw from the study, we will keep the information about you that we have already obtained. To safeguard your rights, we will use the minimum personally-identifiable information possible.

You can find out more about how we use your information