Lucille Kelsall-Knight summarises a recent study reminding clinicians of the need for greater awareness of the impact of heavy menstrual bleeding.
Women’s experiences of heavy menstrual bleeding and medical treatment: qualitative study1
Recent surveys report that 27-36% of women suffer from heavy menstrual bleeding (HMB)2,3 and it is a common reason for consultation in primary care.4 It is widely recognised that HMB can affect the physical, social, emotional and material quality of life.5,6
Dutton and Kai (2022)1 aimed to explore women’s experiences of HMB and their medical treatment up to 10 years after initial management in general practice. Between August 2019 and December 2020, they undertook semi-structured interviews with 36 women who had participated in medical treatments for HMB. The interviews were all conducted by a female health service researcher either face to face in women’s homes or by telephone.
Following thematic analysis, four themes were determined: the impact of HMB and its taboo; understanding and making sense of HMB; quality of interaction with healthcare professionals; and influences on treatment choices and experiences of use.
The women revealed they had frequently normalised their experience despite the wide-ranging and debilitating impacts HMB was having on their lives. They often delayed seeking help for a number of years due to the taboo of menstrual bleeding and because they believed that it was self-treatable.
Their experiences of medical treatments varied, but were influenced by the interactions they had with clinicians. The women seeking treatment were also influenced by health concerns, family and peers, fertility and impending menopause.
The main limitation of the study was that the majority of the participants were ethnically similar; interviews with women from more diverse communities may have yielded a wider range of responses.
Overall, the research highlighted the need for greater awareness among clinicians of the impact of heavy menstrual bleeding on women. Women have different experiences and influences regarding their treatment, therefore a person-centred approach is vital to ensure their needs can be understood and met.
References
- Dutton, B, Kai, J. Women’s experiences of heavy menstrual bleeding and medical treatment: Qualitative study. British Journal of General Practice 20 December 2022; BJGP.2022.0460. DOI: 10.3399/BJGP.2022.0460. Link
- Bitzer J, Serrani M, Lahav A. Women’s attitudes towards heavy menstrual bleeding and their impact on quality of life. J Contracept. 2013;4:21-8. Link
- Fraser I, Mansour D, Breymann C, et al. Prevalence of heavy menstrual bleeding and experiences of affected women in a European patient survey. Int J Gynaecol Obstet. 2015;128(3):196-200.
- National Institute for Health and Care Excellence. Heavy menstrual bleeding: assessment and management. NICE guideline [NG88]. Last updated: 31 March 2020. Link
- Matteson K, Phipps M, Raker C, et al. Discussion: ‘Treatment of symptomatic uterine fibroids’ by van der Kooij et al. Am J Obstet Gynecol. 2010;203(2):e1-e6. Link
- Frick K, Clark M, Steinwachs D, et al. Financial and quality-of-life burden of dysfunctional uterine bleeding among women agreeing to obtain surgical treatment. Women’s Health Issues. 2009;19(2):70-
Lucille Kelsall-Knight is a lecturer in children’s nursing at University of Birmingham School of Nursing. Read more of her Research Updates here
