Menorrhagia in general practice--disease or illness

Area of Science:

• Women's Health
• Primary Care
• Gynecology

Background:

• Menorrhagia, defined as ≥80 ml blood loss per period, is common in primary care.
• Medical guidelines for menorrhagia focus on this quantitative definition.
• Most women reporting heavy bleeding do not meet the medical criteria for menorrhagia.

Purpose of the Study:

• To explore women's perceptions of menorrhagia.
• To understand women's initial interactions with healthcare professionals regarding heavy bleeding.
• To identify discrepancies between medical and patient-centered models of menorrhagia.

Main Methods:

• Qualitative study involving interviews with women presenting with menorrhagia.
• Exploration of patient experiences, understanding of symptoms, and consultation outcomes.
• Analysis of patient-reported illness models versus the established medical disease model.

Main Results:

• Women perceive menorrhagia based on changes in their menstrual cycle and impact on daily functioning, not solely blood volume.
• Patients often feel their concerns are dismissed by healthcare providers focusing on the medical definition.
• A patient-centered "illness model" emerged, emphasizing subjective experience and functional impact over objective blood loss measurement.

Conclusions:

• The medical disease model of menorrhagia is often irrelevant to women's lived experiences.
• Healthcare providers should consider patient-reported "illness models" in managing menorrhagia.
• Replacing the disease model with illness models may improve patient satisfaction and care for heavy menstrual bleeding.