Menorrhagia, defined clinically as menstrual blood loss in excess of 80 ml per cycle, is a common gynaecological complaint that presents both to primary and secondary care. The aim of this review of the literature is to discuss current opinion in the investigation and management of menorrhagia. As menorrhagia is a subjective condition that is difficult and impractical to assess objectively, this review incorporates patient-centred outcomes such as patient satisfaction and continuation with treatment together with more traditional outcomes such as percentage reduction in menstrual loss. As there are many treatment options available, with no one option being superior in all respects, patient choice and treatment preferences should be taken into account when deciding upon management.