Women's health toolkit

This Women’s Health Hub is categorised into sections best representing the needs of women at different stages of their lives.

Clinical resources for training and appraisal

The RCGP Women's Health Library

The RCGP Women’s Health Library has been developed in conjunction with The Royal College of Obstetricians and Gynaecologists (RCOG) and The Faculty of Sexual and Reproductive Healthcare (FSRH) to provide educational resources and guidelines on women’s health that are relevant to GPs and other primary healthcare professionals. These resources will be helpful for those who wish to develop a more specialised interest in women's health.

NICE Guidelines and pathways

NICE Guideline (NG88) Heavy Menstrual Bleeding: assessment and management. March 2018, updated 2021

The Guideline covers the assessment and management of women with heavy menstrual bleeding. It aims to help healthcare professionals appropriately investigate the causes of the heavy periods that are affecting a woman’s quality of life and to offer information and access to treatments allowing the woman to choose the right treatment for her dependent on her priorities and preferences.

The NICE NG88 guideline includes a pathway for improving the assessment and management of heavy menstrual bleeding.

NICE Guideline (NG73): Endometriosis: diagnosis and management. September 2017.

This Guideline covers the diagnosis and management of endometriosis. It aims to raise awareness of the symptoms with an ambition to reduce the short and long-term consequences of untreated endometriosis. It also provides advice on the treatment options available.

The NICE NG88 guideline includes a pathway for improving the diagnosis and management of endometriosis

UK Guidance

The RCOG Green Top Guideline: Long-term consequences of Polycystic Ovary Syndrome

Polycystic Ovary Syndrome is one of the commonest endocrine disorders of women of reproductive age. It is often complicated by chronic anovulatory infertility and hyperandrogenism, with the clinical manifestations of oligomenorrhoea, hirsutism and acne. Many women with the condition are obese and have long-term consequences of impaired glucose tolerance, type 2 diabetes and adverse cardiovascular risk profile. Women with obesity and chronic anovulation are also at risk of endometrial hyperplasia and cancer.

This guideline provides information, based on clinical evidence, on the advice required for women about the long-term health consequences of what is fundamentally an endocrine disorder.

RCOG Green Top Guideline: Management of endometrial hyperplasia

Endometrial cancer is the most common gynaecological malignancy in the Western world and endometrial hyperplasia is its precursor. The most common presentation of endometrial hyperplasia is abnormal uterine bleeding including heavy menstrual bleeding, intermenstrual bleeding, irregular bleeding, unscheduled bleeding on hormone replacement therapy and postmenopausal bleeding.

The 'RCOG Green Top Guideline: Management of endometrial hyperplasia' provides recommendations regarding the management of endometrial hyperplasia.

FSRH CEU Clinical Guidance: Problematic Bleeding with hormonal contraception

Management of women presenting with problematic bleeding while using hormonal contraception is a frequent challenge. It may result from the contraceptive method or from other causes. This guidance provides evidence-based recommendations and good practice points for health professionals on the management of problematic bleeding in women using hormonal contraception currently available in the UK.

RCOG Green Top Guideline: Premenstrual Syndrome, Management (Green-top Guideline No. 48)

Premenstrual syndrome (PMS) affects an estimated 4 in ten women with 5-8% of these women suffering with severe symptoms. Women may be affected by a range of psychological symptoms including depression, anxiety, irritability, lack of confidence and mood swings and also by physical symptoms including bloating and mastalgia.

The aim of this guideline is to review the diagnosis, classification and management of PMS.

European Guidance

Management of women with endometriosis. Guideline of the European Society of Human Reproduction and Embryology

This guideline offers best practice advice on the care of women with suspected and proven endometriosis. The guideline includes recommendations on the diagnostic approach for endometriosis, including which symptoms suggest the diagnosis, use of diagnostic medical technologies and of clinical examination. Treatments for endometriosis, as medical treatment, non-pharmacological treatment and surgery, are discussed for both relief of painful symptoms and for infertility due to endometriosis.

Information is also included for the management of patients in whom endometriosis is found incidentally (without pain or infertility), for primary prevention of endometriosis, for the treatment of menopausal symptoms in patients with a history of endometriosis and for women with questions about the possible association of endometriosis and malignancy.

Management of women with premature ovarian insufficiency. Guideline of the European Society of Human Reproduction and Embryology

This guideline offers best practice advice on the care of women with premature ovarian insufficiency (POI), both primary and secondary. The recommendations are for women younger than 40 years (which includes Turner Syndrome patients) and those who are older with disease onset before 40.

The guideline includes recommendations on the initial assessment and management of women with POI, including with hormonal treatment. POI has consequences for health apart from gynaecological issues, including fertility and contraception, bone health, cardiovascular issues, psychosexual function, psychological function, and neurological function and recommendations about the management are also included.

International evidence-based guideline for the assessment and management of polycystic ovary syndrome (PCOS)

This international evidence-based guideline aims to provide health professionals, consumers and policy makers with transparent evidence-based guidance on timely diagnosis, accurate assessment and optimal treatment of PCOS, to reduce variation in care, optimise prevention of complications and improve health outcomes.

Quality Standards

NICE Quality standards help you improve the quality of care provided or commissioned. Relevant NICE Quality Standards:

Additional resources

RCGP Endometriosis elearning

This free-to-access 30 minute course uses the recommendations of the NICE guideline on endometriosis to follow a case study typically seen in primary care. The case illustrates common issues with diagnosis, when to investigate, when and how to manage in primary care and when to refer.

An educational grant was received from Endometriosis UK to produce this course.

RCGP Heavy Menstrual Bleeding elearning

This free-to-access 30 minute course applies the recommendations of the NICE guideline on HMB using case studies commonly seen in primary care. The cases illustrate common issues with diagnosis, when to investigate, when and how to manage in primary care and when to refer.

An educational grant was received from Endometriosis UK to produce this course.

NICE Clinical Knowledge Summaries (CKS)

Providing primary care practitioners with a readily accessible summary of the current evidence base and practical guidance on best practice:

Guidelines in Practice:

This 'Heavy menstrual bleeding: new treatments offer more options' article discusses the updated NICE recommendations for the diagnosis and treatment of heavy menstrual bleeding including:

  • Advances in techniques, medication and equipment for the management of HMB
  • When a physical examination and/or further investigation is required
  • Benefits of out-patient hysteroscopy vs ultrasound scanning when investigating HMB.

Other Resources: