For many years, traditional management of menorrhagia relied on over-investigation, ineffective drugs and early recourse to major surgery. This article will not only focus on why, which and how a woman with menorrhagia should be investigated, but examine the definition of menorrhagia as a symptom and dysfunctional uterine bleeding as a diagnosis. The article will also address the most recent advances in the rationale for medical and surgical techniques, that may make major surgery for dys-functional uterine bleeding go the way of the D&C, into history.