Heavy menstrual bleeding is a common symptom amongst women of reproductive age, yet questions remain about why some women experience this as a problem while others do not. We investigated the concerns of women who reported heavy menstrual bleeding on questionnaire.
A cross-sectional postal survey and qualitative interviews were carried out amongst a community-based sample of women in Lothian, Scotland. 906 women aged 25 to 44 reported heavy or very heavy periods in response to a postal survey of 2833 women registered with 19 general practices. Amongst those who had reported heavy menstrual bleeding, analysis was carried out of responses to the free text questionnaire item, "What bothers you most about your periods?" In addition, 32 of these women participated in qualitative interviews and their accounts were analysed to explore how menstrual symptoms and 'problems' with periods were experienced.
Even amongst this subgroup of women, selected on the basis of having reported their periods as heavy in the survey, pain was the aspect of their periods that 'most bothered' them, followed by heaviness, mood changes or tiredness, and irregularity or other issues of timing. Interviewees' accounts similarly suggested that a range of menstrual symptoms were problematic and some women did not disentangle which was worst. Judgements of periods as a problem were based on the impact of menstrual symptoms on daily life and this was contingent on social circumstances such as type of paid work and other responsibilities. Although women spoke readily of whether their periods were a problem, there was less clarity in accounts of whether or not menstrual loss was 'heavy'; women said they made judgements based on what was normal for them, degree of difficulty in containing blood loss and pattern of loss.
Women with heavy periods are bothered by a range of menstrual symptoms and their impact on everyday life. Clinical emphasis should be on clarifying the presenting problem and providing help and advice for this, as well as on excluding serious disease. Sometimes simple approaches, such as help with analgesia, may be all that is required.
The results below are discovered through our pilot algorithms. Let us know how we are doing!
- 1. Santer M, Warner P, Wyke S: A Scottish postal survey suggested that the prevailing clinical preoccupation with heavy periods does not reflect the epidemiology of reported symptoms and problems. J Clin Epidemiology 2005, 58(11):1206-1210.
- 2. Coulter A, McPherson K, Vessey M: Do British women undergo too many or too few hysterectomies? Soc Sci Med 1988, 27:987-994.
- 3. Office of Population Censuses and Surveys Department of Health: Morbidity statistics from general practice. Fourth national morbidity study 1991-1992. London, HMSO 1995.
- 4. Scambler A, Scambler G: Menstrual symptoms, attitudes and consulting behaviour. Social Science and Medicine 1985, 20(10):1065-1068.
- 5. O'Flynn N, Britten N: Menorrhagia in general practice - disease or illness? Soc Sci Med 2000, 50(5):651-61.
- 6. Protheroe J, Chew-Graham C: The role of primary care in the diagnosis and management of menorrhagia: a qualitative study of women with menorrhagia. Primary Health Care Research and Development 2005, 6:217-223.
- 7. Warner P, Critchley HOD, Lumsden M-A, Campbell-Brown M, Douglas A, Murray G: Referral for menstrual problems: cross sectional survey of symptoms, reasons for referral, and management. BMJ 2001, 323:24-8.
- 8. Lethaby A, Farquhar C: Treatments for heavy menstrual bleeding. BMJ 2003, 327:1243-4.
- 9. O'Flynn N, Britten N: Diagnosing menstrual disorders: a qualitative study of the approach of primary care professionals. Br J Gen Practice 2004, 54:353-358.
- 10. Little P, Everitt H, Williamson I, Warner G, Moore M, et al.: Observational study of effect of patient centredness and positive approach on outcomes of general practice consultations. BMJ 2001, 323:908-911.
- 11. Stewart M: Studies of health outcomes and patient-centred communication. In Patient-centred medicine Edited by: Stewart M, Brown JB, Weston WW, et al. Thousand Oaks, CA: Sage Publications; 1995:117-131.
- 12. Seale C: The quality of qualitative research London: Sage; 1999.
- 13. Warner P, Critchley HOD, Lumsden M-A: Is the 80 ml blood loss criterion useful in the management of complaint of menorrhagia? Am J Obstetrics & Gynecology 2004, 190:1224-1229.
No related research data.
No similar publications.