OBJECTIVES: Heavy menstrual bleeding (HMB) is defined as excessive menstrual bleeding which interferes with a woman’s quality of life. Despite availability of surgical and non-surgical treatments, HMB remains a public health issue with a prevalence of 4-10%. The objective was to examine why many women do not receive medication to treat their HMB.  METHODS: The number of visits to physician offices for HMB (ICD-9 code 626.2) in 2009 was collected using SDI’s Physician Drug and Diagnostic Audit (PDDA). Additional visit-level data was collected through PDDA, including: the number of visits resulting in a prescription for HMB, the number of visits where patients requested a prescription and other confounding variables such as 1st or subsequent visit, disease severity and comorbidities. The impact of these factors on the likeliness of a patient receiving a prescription for the treatment of HMB was explored. Surgical treatments were not considered in this analysis. RESULTS: In 2009, there were 2,341,000 patient visits to physicians where the primary focus of the visit was the patient’s HMB. Overall, patients received a prescription for the treatment of their HMB in 59% of visits. Among the visits with a prescription, only 18% of prescriptions were requested by the patient. Yet, those who requested a prescription were more likely to receive one (73% vs. 57%). Differences existed between prescription and non-prescription groups. GPs were more likely to prescribe for HMB than OB/GYNs (77% vs. 58%). Patients were more likely to request drugs on their first visit versus subsequent doctor visits (54% vs. 46%). CONCLUSIONS: This preliminary analysis demonstrates that although patient visits for HMB are relatively common, few women are actually requesting treatment for their HMB and not all receive medication for their disease. There is a need for further research to determine the factors that contribute to this discrepancy.