Pamela Warner
Referral for menstrual problems: cross sectional survey of symptoms, reasons for referral, and management
Faculty of Public Health|University of Edinburgh|MRC Centre for Reproductive Health|Mother Hospital|University of Glasgow|Glasgow Royal Infirmary
describe menstrual experience women referred menstrual problems particular menorrhagia excessive menstrual loss assess associations reasons referral given general practitioners womens understanding reasons attendance hospital clinics clinic outcomequestionnaire survey partial review case notes 8 monthsthree hospital gynaecology clinics glasgow edinburgh952 women completed questionnaire first 665 reviewedreason referral womens reported menstrual problems reason clinic attendance diagnosis treatmentonly 38 95 confidence interval 34 41 women reported excessive menstrual loss severe problem however 60 5763 gave reason attending clinic 76 7379 general practitioners gave reason referral reason referral significantly biased towards bleeding mcnemar odds ratio 401 30 53 p0001 pain 054 04 07 p0001 dysfunctional uterine bleeding diagnosed 37 3142 259 women gave reason attendance something bleeding women economically disadvantaged differed prevalence main diagnoses likely fail reattend hysterectomy associated referral bleeding relative risk 49 16 156 p0001 patient stating bleeding reason clinic attendanceintolerance volume bleeding key feature among women attending clinics bleeding problems broad menstrual complaint tends reframed excessive bleeding referral management may result women receiving inappropriate care conceptualisation assessment menorrhagia requires reconsideration