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Heavy menstrual bleeding needs more attention

Blog 16 July 2012

Tony Falconer, RCOG President

Dr Tony Falconer, RCOG President, writes…

Many women suffering from heavy menstrual bleeding (HMB) wait over a year before being referred to secondary care found the second annual report of the HMB Audit published last week.

This is a major project commissioned by the Healthcare Quality Improvement Partnership (HQIP) and is led by the Office for Research and Clinical Audit (ORCA) at the Royal College of Obstetricians and Gynaecologists (RCOG), in collaboration with the London School of Hygiene & Tropical Medicine and Ipsos MORI. However it’s not always easy to get people talking about HMB and raise awareness of this issue.

HMB affects around 80,000 women in England and Wales each year, and for many, it can seriously affect their day-to-day quality of life. This condition must not be overlooked and the audit is a great step in improving care in this area. We are now in the second stage of the audit which involves seeking views directly from women asking them about their experience of HMB and the care they receive.

NICE guidelines recommend that medical treatment is offered in primary care, however the latest findings from the audit show that many women are not receiving care at this level and also that many have to wait over a year before being referred. These women may be in severe pain and discomfort despite the fact that medical treatments are available and can ease symptoms. If these options don’t work, then surgical alternatives including endometrial ablation and hysterectomy can be considered.

It is clear to me that more needs to be done to address this issue and to ensure national guidelines are followed. The question that comes to my mind is why aren’t women receiving the treatment they need at primary care level? One solution may be more training for GPs in this area so they recognise the condition and offer appropriate care to help relieve symptoms.

The next phase of the audit will look at women’s experiences in secondary care and at the end of this project recommendations will be made to improve patient care.

Pregnancy and birth stories may hit the headlines but I hope the results of this audit will raise awareness of this condition and encourage women to seek treatment and lead a more active life.

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