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Heavy menstrual bleeding affects many women

Blog 31 July 2014

Professor Alan Cameron, Vice President (Clinical Quality), writes…

The condition heavy menstrual bleeding is sometimes overlooked and not talked about much, but it is a serious condition and affects around one in four women aged between 15 and 50.

It can interfere with a woman’s physical, social and emotional quality of life and each year approximately 30 000 women undergo surgical treatment for heavy menstrual bleeding across England and Wales.

There are procedures to alleviate the symptoms and we are determined to improve care women receive in this area.

Four years ago the National HMB Audit on this topic kicked off, led by us in partnership with the London School of Hygiene & Tropical Medicine (LSHTM) and Ipsos MORI, and now has now come to an end with some interesting results, showing positive steps and revealing where we need to do more work.

It looked at patient outcomes and experience of treatment for women with heavy menstrual bleeding. Overall treatment has improved and 90% of women rated their care as good, very good or excellent.

Moreover most women had a large improvement in their quality of life in the year following their first gynaecological outpatient appointment.

However, there is much more work to be done in this area and the audit revealed considerable variation in the hospital treatments women received. For example, the percentage of women who had some form of surgical treatment varied between 20% and 60% across NHS hospitals.

The results presented in this report will allow NHS hospitals to review the treatments they offer.

The audit also found differences in the treatment, outcomes and care received in hospital by women of differing ethnicity and socio-economic status. Overall, women from a white ethnic background and those from less deprived areas were more likely to have surgical treatment and experience a greater improvement of their condition in the year after their first outpatient clinic visit than their non-white and more deprived counterparts.

This report highlights the need for further work to understand the access to care for non-white women and for women from more deprived areas.

These important findings allow us as a College to assess the extent to which the NICE guidelines and our own standards are being followed in clinical practice.

This final report makes a number of recommendations to improve services including reviewing existing referral pathways between primary and secondary care, improve information provided to women and to review the care provided to women of non-white ethnicity and those from more socio-economically deprived areas.

I would like to thank all the women who participated in this four year audit as without them this report would have been impossible. Over 8,000 women took part and the questionnaires they filled out provided us with invaluable information into their experience, treatment and satisfaction levels.

This data significantly advances our knowledge and understanding of the treatment and care received by women in hospital for HMB, and the impact on their quality of life.

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