Experiences of women referred for urgent assessment of postmenopausal bleeding (PMB)

Rachel Tarling, Alison Gale, Pierre L. Martin‐Hirsch, Lewis B. Holmes, Kavitha Kanesalingam, Paola Dey
In: Journal of Obstetrics and Gynaecology · 2013 · vol. 33(2) , pp. 184–187 · doi:10.3109/01443615.2012.740529 · PMID:23445145 · W2021612681
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This study found that women referred for urgent postmenopausal bleeding assessment experienced significant anxiety, exacerbated by a lack of knowledge, which decreased by 90 days but remained higher in those not undergoing hysteroscopy.

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Abstract

Women with postmenopausal bleeding (PMB) are referred for specialist assessment within 2 weeks of presentation to their GP. No research has previously examined women's experiences of expedited referral. This was investigated in the present study using questionnaires (6-item State Anxiety Inventory (6-STAI)) and focus groups. A total of 55 women completed questionnaires. Results showed high levels of anxiety at first hospital visit (mean 47.0 (SD 14.27); 95% CI 43.14-50.93). Scores declined by 90 days, but were higher in those not undergoing hysteroscopy. Fifteen women who underwent hysteroscopy attended focus groups. Women recalled fear of cancer from symptom onset until receipt of results. Anxiety was exacerbated by poor knowledge of PMB and lack of awareness of expedited referral. Post-discharge, those with unexplained or recurrent symptoms expressed frustration and upset. Effective strategies to raise awareness of PMB and its causes are needed, including reasons for expedited referral. Women without cancer may also need more support.

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