ArticleBMJ (Clinical research ed.)2001
Referral for menstrual problems: cross sectional survey of symptoms, reasons for referral, and management.
Article in BMJ (Clinical research ed.), 2001. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 3 syntheses or guidelines pooled it, 99 citations in OpenAlex.
- Endometrial resection and ablation techniques for heavy menstrual bleeding.The Cochrane database of systematic reviews · 2019Pooled it
- Endometrial sampling in low-risk patients with abnormal uterine bleeding: a systematic review and meta-synthesis.BMC family practice · 2018Pooled it
- Systematic review highlights difficulty interpreting diverse clinical outcomes in abnormal uterine bleeding trials.Journal of clinical epidemiology · 2011Pooled it
- Low dose dexamethasone as treatment for women with heavy menstrual bleeding: A response-adaptive randomised placebo-controlled dose-finding parallel group trial (DexFEM).EBioMedicine · 2021Trial
- Trial
- Article
- Clinical utility of the PBAC score in quantifying treatment response to hysteroscopy: a retrospective observational study.Frontiers in surgery · 2025Article
- The need to screen for anemia in exercising women.Medicine · 2021Article
- KNOWLEDGE OF MENSTRUAL DISORDERS AND HEALTH SEEKING BEHAVIOUR AMONG FEMALE UNDERGRADUATE STUDENTS OF UNIVERSITY OF IBADAN, NIGERIA.Annals of Ibadan postgraduate medicine · 2021Article
- Article
- The Effectiveness of Levonorgestrel-Releasing Intrauterine System in the Treatment of Heavy Menstrual Bleeding.Journal of obstetrics and gynaecology of India · 2016Article
- More Than Needles: The Importance of Explanations and Self-Care Advice in Treating Primary Dysmenorrhea with Acupuncture.Evidence-based complementary and alternative medicine : eCAM · 2016Article
- Screening of von Willebrand disease in Iranian women with menorrhagia.Iranian Red Crescent medical journal · 2015Article
- Recent advances in managing and understanding menstrual disorders.F1000prime reports · 2015Review
- Screening bleeding disorders in adolescents and young women with menorrhagia.Turkish journal of haematology : official journal of Turkish Society of Haematology · 2013Article
- Does Ramadan fasting has any effects on menstrual cycles?Iranian journal of reproductive medicine · 2013Article
- Molecular and functional aspects of menstruation in the macaque.Reviews in endocrine & metabolic disorders · 2012Review
- What aspects of periods are most bothersome for women reporting heavy menstrual bleeding? Community survey and qualitative study.BMC women's health · 2007Article
- Diagnosing menstrual disorders: a qualitative study of the approach of primary care professionals.The British journal of general practice : the journal of the Royal College of General Practitioners · 2004Article
- Periods and well-being: A focus group study to discuss how menstruation affects the well-being of women aged 18-40.Women's health (London, England)Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo describe the menstrual experience of women referred for menstrual problems, in particular menorrhagia (excessive menstrual loss), and to assess associations with reasons for referral given by their general practitioners, the women's understanding of the reasons for their attendance at the hospital clinics, and clinic outcome.
designQuestionnaire survey, with partial review of case notes after 8 months.
settingThree hospital gynaecology clinics in Glasgow and Edinburgh.
participants952 women completed the questionnaire, and the first 665 were reviewed. OUTCOME MEASURES: Reason for referral, women's reported menstrual problems and reason for clinic attendance, diagnosis, and treatment.
resultsOnly 38% (95% confidence interval 34% to 41%) of women reported excessive menstrual loss as a severe problem. However 60% (57-63%) gave it as reason for attending a clinic, and 76% (73-79%) of general practitioners gave it as reason for referral. Reason for referral was significantly biased towards bleeding (McNemar odds ratio 4.01, 3.0 to 5.3, P<0.001) and against pain (0.54, 0.4 to 0.7, P<0.001). Dysfunctional uterine bleeding was diagnosed in 37% (31-42%) of the 259 women who gave as reason for attendance something other than bleeding. Women who were economically disadvantaged differed in prevalence of the main diagnoses and were more likely to fail to reattend. Hysterectomy was associated with referral for bleeding (relative risk 4.9, 1.6 to 15.6, P<0.001) but not with the patient stating bleeding as the reason for clinic attendance.
conclusionsIntolerance of the volume of their bleeding is not a key feature among women attending clinics for bleeding problems. Broad menstrual complaint tends to be reframed as excessive bleeding at referral and during management. This may result in women receiving inappropriate care. Conceptualisation and assessment of menorrhagia requires reconsideration.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.