Heavy menstrual bleeding: a global survey of health care practitioners’ perceptions

Abstract

Objectives: This study sought to assess the perceptions of health care practitioners (HCPs) regarding heavy menstrual bleeding (HMB).

Methods: We developed an online survey for HCPs administered in 10 countries (Brazil, Canada, China, France, Germany, Korea, Russia, Spain, UK and USA), in order to assess their perceptions regarding HMB.

Results: We received 1032 responses. Most HCPs considered more than 7 days of bleeding abnormal. There was a significant difference in the definition of HMB between countries (p < .001). Most HCPs measured menstrual blood loss by the number of sanitary pads or tampons needed, followed by the impact on patients’ daily activities. The majority of HMB patients (61%) were diagnosed as having a non-structural disorder with no causative identifiable coagulopathy. Patient acceptance and compliance were each relevant for the treatment decisions of half of the HCPs. Treatment options for idiopathic HMB featured mainly oral contraceptives and the levonorgestrel-releasing intrauterine system. Surgery was mentioned as a treatment option for idiopathic HMB by 44% of HCPs.

Conclusion: The definition of HMB and HCP perceptions of HMB regarding diagnostic and therapeutic issues varied between countries. Surgery was mentioned as a treatment for idiopathic HMB by nearly half of HCPs. Clinician education is greatly needed to improve the management of women with HMB.

摘要

目标：本研究旨在评估医务工作者（HCP）关于严重月经出血（HMB）的看法。

方法：我们对10个国家（巴西, 加拿大, 中国, 法国, 德国, 韩国, 俄罗斯, 西班牙, 英国和美国）的HCP进行了在线调查, 评估他们对HMB的看法。

结果：我们收到了1032条回复。大多数HCP认为HMB是异常出血超过7天。各国之间HMB的定义存在显著差异（p <.001）。大多数HCP通过患者所需卫生巾或卫生棉条的数量来测量月经失血量, 这对患者的日常活动有所影响。大多数HMB患者（61%）被诊断为非结构性疾病, 无可识别致病性的凝血障碍。一半HCP认为患者接受度和依从性均与HCP的治疗决策相关。特发性HMB的治疗选择主要包括口服避孕药和左炔诺孕酮释放宫内系统。 44% 的HCPs将手术作为特发性HMB的治疗选择。

结论：HMB的定义和HCP对HMB的诊断和治疗选择因国家而异。近一半的HCP提到手术可治疗特发性HMB。迫切需要临床教育来改善HMB女性的管理。

Keywords:

• Healthcare practitioners
• heavy menstrual bleeding
• knowledge
• PALM-COEIN

Disclosure statement

ALSF is a member of the HELP group, a panel of independent physicians with an expert interest in HMB, the formation of which was facilitated by Bayer HealthCare Pharmaceuticals. The contents of this article are the sole responsibility of the authors. ALSF and ALLR have acted as consultants to Bayer HealthCare Pharmaceuticals and have received consultancy honoraria.