In this episode Dr Bek Ledingham chats to Dr Talat Uppal about Heavy menstrual bleeding in a peri-menopausal woman. We recorded it on World Menopause day we aim to share up to date information about managing this common problem that often does not get the attention it deserves.  Key take home messages-  1) Initiate treatment of symptomatic women at the first visit  2) Order pelvic ultrasound day 5-10 of cycle 3) Mirena is the most effective management option 4) Uterus sparing surgical procedures are preferred to hysterectomy.  References mentioned during the show  https://www.safetyandquality.gov.au/publications-and-resources/resource-library/heavy-menstrual-bleeding-clinical-care-standard-2017 https://www.jeanhailes.org.au/health-a-z/menopause?gclid=Cj0KCQjwtrSLBhCLARIsACh6RmgRy9D2b18efnY6i4-2CiA4us-55aTwNLLQXUBegh9VJuwDn6gPGfwaAkbvEALw_wcB https://ranzcog.edu.au/womens-health/patient-information-resources/heavy-menstrual-bleeding https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/recovering-well/endometrial-ablation-for-print.pdf http://oxfordstmedical.com.au/wp-content/uploads/2021/05/Mirena-Information-Booklet.pdf https://ranzcog.edu.au/RANZCOG_SITE/media/RANZCOG-MEDIA/Women%27s%20Health/Patient%20information/Hysterectomy-pamphlet.pdf?ext=.pdf http://www.cincyobgyn.com/webdocuments/novasure-brochure.pdf ________________________________________________________________________________________________________________________________________ Dr Talat Uppal is an Obstetrician & Gynaecologist who currently works both at the Northern Beaches and Hornsby Ku-ring-gai Hospitals as a Visiting Medical Officer. She is the Director of Women’s Health Road, and has set up an innovative integrated multidisciplinary ‘Journey’ model with a strong family centred approach to maternity care. www.womenshealthroad.com.au She is also a Clinical Senior lecturer in Obstetrics and Gynaecology at Northern Medical School, University of Sydney. Her previous, decade long role was based at Manly and Mona Vale Hospitals, as a Senior Obstetrics Staff Specialist and Clinical Director of Women’s, Children & Family health. She is the past Chair of both the NSW State Reference Committee and NSW RANZCOG Education Subcommittee She is a Fellow of the Australian Association for Quality in Health Care as well as a Fellow of the Australasian College of Health Service Management She is the ex  joint co-ordinator of Diploma (DRANZCOG) OSCE examination as her special interest is supporting the role of General Practitioners in the Women’s health context. She is an RANZCOG media spokesperson. She is fluent in 3 languages and has much overseas exposure with volunteer teaching work.