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Factors predicting choice of treatment for menorrhagia in gynaecology outpatient clinics

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  • Vuorma, Sirkku
  • Rissanen, Pekka
  • Aalto, Anna-Mari
  • Kujansuu, Erkki
  • Hurskainen, Ritva
  • Teperi, Juha

Abstract

The aim of this prospective study was to investigate factors predicting choice of treatment for excessive menstrual bleeding, with special emphasis on women's pre-treatment preference. A cohort of women with heavy menstruation and their treatment process in gynaecology outpatient clinics were followed-up for 1Â yr. A total of 383 35-54-yr-old women attending 14 Finnish hospitals participated. They completed a questionnaire before their first outpatient clinic visit, and postal follow-ups were conducted 3 and 12 months later. Information on treatment(s) during the follow-up was taken from medical records and questionnaires. The choice between hysterectomy and conservative treatments, and fulfillment of pre-treatment preference were the main outcome measures. During the 1-yr follow-up, 51% (n=196) of the women underwent hysterectomy and nine were still awaiting it, 12% (n=44) had a minor surgical procedure, 11% (n=41) had oral medication, 9% (n=33) used a hormonal intrauterine system, and nine women changed preventive method. Forty-two women (11%) reported having had no treatment. Data on previous treatments suggested that conservative treatment modalities were under-used. Most of the treatment decisions were made within the first 3-month period. Women's pre-treatment preference was the strongest predictor of chosen treatment. Unemployment, irregular periods and anxiety decreased the probability of a decision for hysterectomy, while pelvic pain and inconvenience due to bleeding increased it. The treatment plan accorded with pre-treatment preference in 72% of the women preferring hysterectomy and in 74% of those preferring a conservative option.

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  • Vuorma, Sirkku & Rissanen, Pekka & Aalto, Anna-Mari & Kujansuu, Erkki & Hurskainen, Ritva & Teperi, Juha, 2003. "Factors predicting choice of treatment for menorrhagia in gynaecology outpatient clinics," Social Science & Medicine, Elsevier, vol. 56(8), pages 1653-1660, April.
  • Handle: RePEc:eee:socmed:v:56:y:2003:i:8:p:1653-1660
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