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NICE \u0aae\u0abe\u0ab0\u0acd\u0a97\u0aa6\u0ab0\u0acd\u0ab6\u0abf\u0a95\u0abe \u0aae\u0ac1\u0a9c\u0aac \u0a85\u0ab8\u0ab0\u0a95\u0abe\u0ab0\u0a95\u0aa4\u0abe\u0aa8\u0ac1\u0a82 \u0aae\u0ac2\u0ab2\u0acd\u0aaf\u0abe\u0a82\u0a95\u0aa8 \u0a95\u0ab0\u0ab5\u0abe \u0aae\u0abe\u0a9f\u0ac7 IUS \u0aa8\u0ac7 6 \u0aae\u0ab9\u0abf\u0aa8\u0abe \u0aae\u0abe\u0a9f\u0ac7 \u0ab0\u0abe\u0a96\u0ab5\u0abe\u0aa8\u0ac0 \u0aad\u0ab2\u0abe\u0aae\u0aa3 \u0a95\u0ab0\u0ab5\u0abe\u0aae\u0abe\u0a82 \u0a86\u0ab5\u0ac7 \u0a9b\u0ac7.<br><br> - \u0a85\u0aae\u0ac7 HMB \u0aa8\u0abe \u0aae\u0ac2\u0ab2\u0acd\u0aaf\u0abe\u0a82\u0a95\u0aa8 \u0a85\u0aa8\u0ac7 \u0ab8\u0abe\u0ab0\u0ab5\u0abe\u0ab0 \u0ab5\u0abf\u0a95\u0ab2\u0acd\u0aaa\u0acb\u0aa8\u0abe \u0aae\u0ac2\u0ab2\u0acd\u0aaf\u0abe\u0a82\u0a95\u0aa8\u0aae\u0abe\u0a82 \u0aae\u0abe\u0ab8\u0abf\u0a95 \u0aa1\u0abe\u0aaf\u0ab0\u0ac0 \u0a9f\u0ac7\u0aae\u0acd\u0aaa\u0ab2\u0ac7\u0a9f\u0aa8\u0acb \u0a89\u0aaa\u0aaf\u0acb\u0a97 \u0a95\u0ab0\u0ab5\u0abe\u0aa8\u0ac0 \u0aad\u0ab2\u0abe\u0aae\u0aa3 \u0a95\u0ab0\u0ac0\u0ab6\u0ac1\u0a82.<br><br> - \u0aa4\u0acd\u0aaf\u0abe\u0ab0\u0aac\u0abe\u0aa6 \u0ab2\u0a95\u0acd\u0ab7\u0aa3\u0acb \u0aa6\u0ac2\u0ab0 \u0a95\u0ab0\u0ab5\u0abe\u0aae\u0abe\u0a82 \u0aa8\u0abf\u0ab7\u0acd\u0aab\u0ab3\u0aa4\u0abe \u0a9c\u0acb\u0ab5\u0abe \u0aae\u0ab3\u0ac0 \u0a9b\u0ac7 (\u0ab8\u0abf\u0ab5\u0abe\u0aaf \u0a95\u0ac7 \u0aa4\u0aac\u0ac0\u0aac\u0ac0 \u0ab0\u0ac0\u0aa4\u0ac7 \u0a85\u0aaf\u0acb\u0a97\u0acd\u0aaf \u0a85\u0aa5\u0ab5\u0abe \u0aac\u0abf\u0aa8\u0ab8\u0ab2\u0abe\u0ab9\u0aad\u0ab0\u0acd\u0aaf\u0ac1\u0a82 \u0ab9\u0acb\u0aaf)<br>\u00a0<br>\u0a85\u0aa8\u0ac7<br>\u00a0<br>\u0aa8\u0ac0\u0a9a\u0ac7\u0aa8\u0ac0 \u0ab8\u0abe\u0ab0\u0ab5\u0abe\u0ab0\u0acb \u0a95\u0abe\u0a82 \u0aa4\u0acb \u0aa8\u0abf\u0ab7\u0acd\u0aab\u0ab3 \u0a97\u0a88 \u0a9b\u0ac7, \u0aaf\u0acb\u0a97\u0acd\u0aaf \u0aa8\u0aa5\u0ac0 \u0a85\u0aa5\u0ab5\u0abe \u0aa8\u0ac7\u0ab6\u0aa8\u0ab2 \u0a88\u0aa8\u0acd\u0ab8\u0acd\u0a9f\u0abf\u0a9f\u0acd\u0aaf\u0ac2\u0a9f \u0aab\u0acb\u0ab0 \u0ab9\u0ac7\u0ab2\u0acd\u0aa5 \u0a8f\u0aa8\u0acd\u0aa1 \u0a95\u0acd\u0ab2\u0abf\u0aa8\u0abf\u0a95\u0ab2 \u0a8f\u0a95\u0acd\u0ab8\u0ac7\u0ab2\u0aa8\u0acd\u0ab8 (NICE) \u0aae\u0abe\u0ab0\u0acd\u0a97\u0aa6\u0ab0\u0acd\u0ab6\u0abf\u0a95\u0abe NG88 \u0ab9\u0ac7\u0ab5\u0ac0 \u0aae\u0ac7\u0aa8\u0acd\u0ab8\u0acd\u0a9f\u0acd\u0ab0\u0ac1\u0a85\u0ab2 \u0aac\u0acd\u0ab2\u0ac0\u0aa1\u0abf\u0a82\u0a97 \u0a85\u0aa8\u0ac1\u0ab8\u0abe\u0ab0 \u0aac\u0abf\u0aa8\u0ab8\u0ab2\u0abe\u0ab9\u0aad\u0ab0\u0acd\u0aaf\u0abe \u0a9b\u0ac7:<br><br>\u2022 \u0a9f\u0acd\u0ab0\u0abe\u0aa8\u0ac7\u0a95\u0acd\u0ab8\u0abe\u0aae\u0abf\u0a95 \u0a8f\u0ab8\u0abf\u0aa1 \u0a85\u0aa8\u0ac7\/\u0a85\u0aa5\u0ab5\u0abe \u0aa8\u0acb\u0aa8-\u0ab8\u0acd\u0a9f\u0ac0\u0ab0\u0acb\u0a88\u0aa1\u0ab2 \u0a8f\u0aa8\u0acd\u0a9f\u0ac0-\u0a88\u0aa8\u0acd\u0aab\u0acd\u0ab2\u0ac7\u0aae\u0ac7\u0a9f\u0ab0\u0ac0 \u0aa6\u0ab5\u0abe\u0a93 (NSAIDs), \u0a9c\u0ac7\u0aae \u0a95\u0ac7 \u0aa8\u0ac7\u0aaa\u0acd\u0ab0\u0acb\u0a95\u0acd\u0ab8\u0ac7\u0aa8<br><br>\u2022 \u0aae\u0acc\u0a96\u0abf\u0a95 \u0ab9\u0acb\u0ab0\u0acd\u0aae\u0acb\u0aa8\u0ab2 \u0aaa\u0aa6\u0acd\u0aa7\u0aa4\u0abf\u0a93, \u0a9c\u0ac7\u0aae \u0a95\u0ac7 \u0ab8\u0a82\u0aaf\u0ac1\u0a95\u0acd\u0aa4 \u0aae\u0acc\u0a96\u0abf\u0a95 \u0a97\u0ab0\u0acd\u0aad\u0aa8\u0abf\u0ab0\u0acb\u0aa7\u0a95, \u0a9a\u0a95\u0acd\u0ab0\u0ac0\u0aaf \u0aae\u0acc\u0a96\u0abf\u0a95 \u0aaa\u0acd\u0ab0\u0acb\u0a9c\u0ac7\u0ab8\u0acd\u0a9f\u0ac7\u0ab0\u0acb\u0aa8<br>\u00a0<br>\u0a85\u0aa8\u0ac7<br>\u00a0<br>\u0a9c\u0ac0\u0ab5\u0aa8\u0aa8\u0ac0 \u0a97\u0ac1\u0aa3\u0ab5\u0aa4\u0acd\u0aa4\u0abe \u0aaa\u0ab0 \u0a97\u0a82\u0aad\u0ac0\u0ab0 \u0a85\u0ab8\u0ab0 \u0ab9\u0acb\u0ab5\u0abe\u0aa8\u0abe \u0aaa\u0ac1\u0ab0\u0abe\u0ab5\u0abe \u0a9b\u0ac7<br>\u00a0<br>\u0a85\u0aa5\u0ab5\u0abe<br>\u00a0<br>\u0a9c\u0acb \u0ab8\u0abe\u0ab0\u0ab5\u0abe\u0ab0 \u0a85\u0ab8\u0aab\u0ab3 \u0ab9\u0acb\u0aaf, \u0aa4\u0acb \u0ab8\u0acd\u0aa4\u0acd\u0ab0\u0ac0 \u0aab\u0abe\u0ab0\u0acd\u0aae\u0abe\u0a95\u0acb\u0ab2\u0acb\u0a9c\u0abf\u0a95\u0ab2 \u0ab8\u0abe\u0ab0\u0ab5\u0abe\u0ab0\u0aa8\u0acb \u0a87\u0aa8\u0a95\u0abe\u0ab0 \u0a95\u0ab0\u0ac7 \u0a9b\u0ac7, \u0a85\u0aa5\u0ab5\u0abe \u0ab2\u0a95\u0acd\u0ab7\u0aa3\u0acb \u0a97\u0a82\u0aad\u0ac0\u0ab0 \u0ab9\u0acb\u0aaf \u0a9b\u0ac7, \u0aa4\u0acb \u0aa8\u0abf\u0ab7\u0acd\u0aa3\u0abe\u0aa4 \u0ab8\u0a82\u0aad\u0abe\u0ab3 \u0aae\u0abe\u0a9f\u0ac7 \u0ab0\u0ac7\u0aab\u0ab0\u0ab2\u0aa8\u0acb \u0ab5\u0abf\u0a9a\u0abe\u0ab0 \u0a95\u0ab0\u0acb: \u0a8f\u0a9a\u0a8f\u0aae\u0aac\u0ac0\u0aa8\u0abe \u0a95\u0abe\u0ab0\u0aa3\u0aa8\u0ac1\u0a82 \u0aa8\u0abf\u0aa6\u0abe\u0aa8 \u0a95\u0ab0\u0ab5\u0abe \u0aae\u0abe\u0a9f\u0ac7 \u0aa4\u0aaa\u0abe\u0ab8, \u0a9c\u0acb \u0a9c\u0ab0\u0ac2\u0ab0\u0ac0 \u0ab9\u0acb\u0aaf \u0aa4\u0acb, \u0aae\u0ab9\u0abf\u0ab2\u0abe \u0aaa\u0abe\u0ab8\u0ac7 \u0aaa\u0ab9\u0ac7\u0ab2\u0ac7\u0aa5\u0ac0 \u0a9c \u0a95\u0ab0\u0ab5\u0abe\u0aae\u0abe\u0a82 \u0a86\u0ab5\u0ac7\u0ab2\u0ac0 \u0a95\u0acb\u0a88\u0aaa\u0aa3 \u0aa4\u0aaa\u0abe\u0ab8\u0aa8\u0ac7 \u0aa7\u0acd\u0aaf\u0abe\u0aa8\u0aae\u0abe\u0a82 \u0ab2\u0ac7\u0aa4\u0abe \u0a85\u0aa8\u0ac7 \u0ab5\u0ac8\u0a95\u0ab2\u0acd\u0aaa\u0abf\u0a95 \u0ab8\u0abe\u0ab0\u0ab5\u0abe\u0ab0 \u0aaa\u0ab8\u0a82\u0aa6\u0a97\u0ac0\u0a93 \u0ab8\u0ab9\u0abf\u0aa4 : \u0aab\u0abe\u0ab0\u0acd\u0aae\u0abe\u0a95\u0acb\u0ab2\u0acb\u0a9c\u0abf\u0a95\u0ab2 \u0ab5\u0abf\u0a95\u0ab2\u0acd\u0aaa\u0acb \u0aaa\u0ab9\u0ac7\u0ab2\u0ac7\u0aa5\u0ac0 \u0a9c \u0a85\u0a9c\u0aae\u0abe\u0ab5\u0ab5\u0abe\u0aae\u0abe\u0a82 \u0a86\u0ab5\u0acd\u0aaf\u0abe \u0aa8\u0aa5\u0ac0 (\u0a85\u0a97\u0abe\u0a89\u0aa8\u0ac0 \u0a9c\u0ac7\u0aae), \u0ab5\u0ac8\u0a95\u0ab2\u0acd\u0aaa\u0abf\u0a95 \u0ab8\u0ab0\u0acd\u0a9c\u0abf\u0a95\u0ab2 \u0ab5\u0abf\u0a95\u0ab2\u0acd\u0aaa\u0acb<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u0aae\u0abe\u0ab0\u0acd\u0a97\u0aa6\u0ab0\u0acd\u0ab6\u0abf\u0a95\u0abe<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td><a href=\"https:\/\/www.pms.org.uk\/app\/uploads\/2019\/10\/NAPS-MENSTRUAL-DIARY.docx\"><strong>https:\/\/www.pms.org.uk\/app\/uploads\/2019\/10\/NAPS-MENSTRUAL-DIARY.docx<\/strong><\/a><br><strong>\u00a0<\/strong><br><a href=\"https:\/\/ebi.aomrc.org.uk\/interventions\/hysterectomy-for-heavy-menstrual-bleeding\/\">\u0aad\u0abe\u0ab0\u0ac7 \u0aae\u0abe\u0ab8\u0abf\u0a95 \u0ab0\u0a95\u0acd\u0aa4\u0ab8\u0acd\u0ab0\u0abe\u0ab5 \u0aae\u0abe\u0a9f\u0ac7 \u0ab9\u0abf\u0ab8\u0acd\u0a9f\u0ab0\u0ac7\u0a95\u0a9f\u0aae\u0ac0 \u2013 EBI (aomrc.org.uk)<\/a><br>\u00a0<br>\u0aad\u0abe\u0ab0\u0ac7 \u0aaa\u0ac0\u0ab0\u0abf\u0aaf\u0aa1\u0acd\u0ab8 \u2013 NHS (www.nhs.uk)<br>\u00a0<br><a href=\"https:\/\/www.nhs.uk\/conditions\/hysterectomy\/\">\u0ab9\u0abf\u0ab8\u0acd\u0a9f\u0ab0\u0ac7\u0a95\u0a9f\u0aae\u0ac0 \u2013 NHS (www.nhs.uk)<\/a><br>\u00a0<br><a href=\"https:\/\/cks.nice.org.uk\/topics\/menorrhagia-heavy-menstrual-bleeding\/\">\u0aae\u0ac7\u0aa8\u0acb\u0ab0\u0ac7\u0a9c\u0abf\u0aaf\u0abe (\u0aad\u0abe\u0ab0\u0ac7 \u0aae\u0abe\u0ab8\u0abf\u0a95 \u0ab0\u0a95\u0acd\u0aa4\u0ab8\u0acd\u0ab0\u0abe\u0ab5) | \u0a86\u0ab0\u0acb\u0a97\u0acd\u0aaf \u0ab5\u0abf\u0ab7\u0aaf A \u0aa5\u0ac0 Z | CKS | \u0ab8\u0ab0\u0ab8<\/a><br>\u00a0<br><a href=\"https:\/\/cks.nice.org.uk\/topics\/menopause\/prescribing-information\/hormone-replacement-therapy-hrt\/\">\u0ab9\u0acb\u0ab0\u0acd\u0aae\u0acb\u0aa8 \u0ab0\u0abf\u0aaa\u0acd\u0ab2\u0ac7\u0ab8\u0aae\u0ac7\u0aa8\u0acd\u0a9f \u0aa5\u0ac7\u0ab0\u0abe\u0aaa\u0ac0 (HRT) | \u0aa8\u0abf\u0ab0\u0acd\u0aa7\u0abe\u0ab0\u0abf\u0aa4 \u0aae\u0abe\u0ab9\u0abf\u0aa4\u0ac0 | \u0aae\u0ac7\u0aa8\u0acb\u0aaa\u0acb\u0a9d | CKS | \u0ab8\u0ab0\u0ab8<\/a><br>\u00a0<br><a href=\"https:\/\/thebms.org.uk\/publications\/bms-joint-guidelines\/management-of-unscheduled-bleeding-on-hormone-replacement-therapy-hrt\/\">\u0ab9\u0acb\u0ab0\u0acd\u0aae\u0acb\u0aa8 \u0ab0\u0abf\u0aaa\u0acd\u0ab2\u0ac7\u0ab8\u0aae\u0ac7\u0aa8\u0acd\u0a9f \u0aa5\u0ac7\u0ab0\u0abe\u0aaa\u0ac0 (HRT) \u0aaa\u0ab0 \u0a85\u0aa8\u0abf\u0ab6\u0acd\u0a9a\u0abf\u0aa4 \u0ab0\u0a95\u0acd\u0aa4\u0ab8\u0acd\u0ab0\u0abe\u0ab5\u0aa8\u0ac1\u0a82 \u0ab8\u0a82\u0a9a\u0abe\u0ab2\u0aa8 - \u0aac\u0acd\u0ab0\u0abf\u0a9f\u0abf\u0ab6 \u0aae\u0ac7\u0aa8\u0acb\u0aaa\u0acb\u0a9d \u0ab8\u0acb\u0ab8\u0abe\u0aaf\u0a9f\u0ac0 (thebms.org.uk)<\/a><\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u0ab5\u0aa7\u0abe\u0ab0\u0abe\u0aa8\u0ac0 \u0aae\u0abe\u0ab9\u0abf\u0aa4\u0ac0<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u0ab8\u0acd\u0aa4\u0acd\u0ab0\u0ac0\u0ab0\u0acb\u0a97\u0ab5\u0abf\u0a9c\u0acd\u0a9e\u0abe\u0aa8 \u0aaa\u0abe\u0aa5\u0ab5\u0ac7 \u0ab6\u0acb\u0aa7\u0a95<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img data-recalc-dims=\"1\" fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"560\" src=\"https:\/\/i0.wp.com\/leicesterleicestershireandrutland.icb.nhs.uk\/wp-content\/uploads\/2024\/05\/image.png?resize=800%2C560&#038;ssl=1\" alt=\"\" class=\"wp-image-17080\" srcset=\"https:\/\/i0.wp.com\/leicesterleicestershireandrutland.icb.nhs.uk\/wp-content\/uploads\/2024\/05\/image.png?resize=1024%2C717&amp;ssl=1 1024w, https:\/\/i0.wp.com\/leicesterleicestershireandrutland.icb.nhs.uk\/wp-content\/uploads\/2024\/05\/image.png?resize=300%2C210&amp;ssl=1 300w, https:\/\/i0.wp.com\/leicesterleicestershireandrutland.icb.nhs.uk\/wp-content\/uploads\/2024\/05\/image.png?resize=768%2C538&amp;ssl=1 768w, https:\/\/i0.wp.com\/leicesterleicestershireandrutland.icb.nhs.uk\/wp-content\/uploads\/2024\/05\/image.png?resize=18%2C12&amp;ssl=1 18w, https:\/\/i0.wp.com\/leicesterleicestershireandrutland.icb.nhs.uk\/wp-content\/uploads\/2024\/05\/image.png?w=1270&amp;ssl=1 1270w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u0a85\u0aa8\u0ac1\u0ab8\u0ac2\u0a9a\u0abf\u0aa4 \u0ab0\u0a95\u0acd\u0aa4\u0ab8\u0acd\u0ab0\u0abe\u0ab5\u0aa8\u0ac1\u0a82 \u0ab8\u0a82\u0a9a\u0abe\u0ab2\u0aa8<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"577\" src=\"https:\/\/i0.wp.com\/leicesterleicestershireandrutland.icb.nhs.uk\/wp-content\/uploads\/2024\/05\/image-1.png?resize=800%2C577&#038;ssl=1\" alt=\"\" class=\"wp-image-17081\" srcset=\"https:\/\/i0.wp.com\/leicesterleicestershireandrutland.icb.nhs.uk\/wp-content\/uploads\/2024\/05\/image-1.png?resize=1024%2C738&amp;ssl=1 1024w, https:\/\/i0.wp.com\/leicesterleicestershireandrutland.icb.nhs.uk\/wp-content\/uploads\/2024\/05\/image-1.png?resize=300%2C216&amp;ssl=1 300w, https:\/\/i0.wp.com\/leicesterleicestershireandrutland.icb.nhs.uk\/wp-content\/uploads\/2024\/05\/image-1.png?resize=768%2C554&amp;ssl=1 768w, https:\/\/i0.wp.com\/leicesterleicestershireandrutland.icb.nhs.uk\/wp-content\/uploads\/2024\/05\/image-1.png?resize=18%2C12&amp;ssl=1 18w, https:\/\/i0.wp.com\/leicesterleicestershireandrutland.icb.nhs.uk\/wp-content\/uploads\/2024\/05\/image-1.png?w=1402&amp;ssl=1 1402w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u0ab6\u0a82\u0a95\u0abe\u0ab8\u0acd\u0aaa\u0aa6 \u0a8f\u0aa8\u0acd\u0aa1\u0acb\u0aae\u0ac7\u0a9f\u0acd\u0ab0\u0abe\u0aaf\u0ab2 \u0aaa\u0ac7\u0aa5\u0acb\u0ab2\u0acb\u0a9c\u0ac0 (SEP) \u0aaa\u0abe\u0aa5\u0ab5\u0ac7<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"655\" height=\"949\" src=\"https:\/\/i0.wp.com\/leicesterleicestershireandrutland.icb.nhs.uk\/wp-content\/uploads\/2024\/05\/image-4.png?resize=655%2C949&#038;ssl=1\" alt=\"\" class=\"wp-image-17084\" srcset=\"https:\/\/i0.wp.com\/leicesterleicestershireandrutland.icb.nhs.uk\/wp-content\/uploads\/2024\/05\/image-4.png?w=655&amp;ssl=1 655w, https:\/\/i0.wp.com\/leicesterleicestershireandrutland.icb.nhs.uk\/wp-content\/uploads\/2024\/05\/image-4.png?resize=207%2C300&amp;ssl=1 207w, https:\/\/i0.wp.com\/leicesterleicestershireandrutland.icb.nhs.uk\/wp-content\/uploads\/2024\/05\/image-4.png?resize=8%2C12&amp;ssl=1 8w\" sizes=\"(max-width: 655px) 100vw, 655px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>ARP 72 \u0ab8\u0aae\u0ac0\u0a95\u0acd\u0ab7\u0abe \u0aa4\u0abe\u0ab0\u0ac0\u0a96: 2027<\/td><\/tr><\/tbody><\/table><\/figure>","protected":false},"excerpt":{"rendered":"<p>This policy provides guidance on the commissioning of hysterectomy for the treatment of heavy menstrual bleeding which is not caused by a structural or pathological abnormality. 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