Heavy menstrual bleeding (HMB) is common and a significant health care burden. The Mirena Intra-Uterine System (IUS) is the superior medical therapy with a comparable improvement in patients’ quality of life to most surgical therapies. Hysterectomy is the definitive treatment but carries higher risks. This audit found that 78% of patients who underwent a hysterectomy over a one-year period at Counties Manukau District Health Board (CMDHB) were offered a Mirena prior to their surgery. This is below our standard of 100%. This result may be underestimated due to insufficient documentation.