Dysfunctional uterine bleeding is the diagnosis in the majority of cases of menorrhagia. The symptom of menorrhagia accounts for a significant proportion of referrals to gynaecologists. There is no hormonal defect in dysfunctional uterine bleeding, however, disturbances in endometrial mediators have been noted. The majority of cases are associated with ovulatory cycles, when cycle control is not an issue, and can thus be treated with non-hormonal methods such as prostaglandin synthetase inhibitors and antifibrinolytics. Those patients with anovulatory cycles may benefit from exogenous control of the pattern of bleeding with hormonal preparations. When effective contraception is also required the use of either the combined oral contraceptive or the levonorgestrel releasing intrauterine system (IUS) are suitable choices. National guidelines exist for the management of menorrhagia. If appropriate attention is made to such guidelines, in addition to the individuals' symptoms and requirements, then the avoidance of inappropriate investigations, referrals and treatments may be achieved. The medical management of dysfunctional bleeding should ideally be based in the community. Referral to hospital being reserved for those cases where menorrhagia is thought to de due to underlying pathology or when initial treatment appears to fail.