Menorrhagia can be treated by drug therapy or surgery. General practitioners (GPs) can prescribe drugs to reduce menstrual blood loss as first-line treatment, referring patients for surgical treatment if drug therapy fails. This study examined the efficacy of drugs used to treat menorrhagia and surveyed British GPs to discover the extent to which they prescribed the most effective drugs for this condition. The results suggest that treatment of this condition in primary care falls short of desirable standards. A meta-analysis of randomized trials of drug therapy revealed wide differences in efficacy and side effects. The most effective drug (tranexamic acid) is little used by British GPs, whereas the least effective drug (norethisterone) is the most frequently prescribed.