Exploring the impact of heavy menstrual bleeding: a mixed-methods analysis of women’s experiences

Mehar Chawla, Lily Nicholson, Luke Nicholson, Bassel Wattar
In: British Journal of General Practice · 2025 · vol. 75(suppl 1) , pp. bjgp25X742041 · doi:10.3399/bjgp25x742041 · PMID:40404406 · W4410594291
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This mixed-methods study examined how heavy menstrual bleeding (HMB) affects women’s quality of life in the UK, using an online survey recruited via social media and analyzed with descriptive statistics for quantitative responses and thematic analysis for open-text answers. Thirty-three participants with current or past self-reported HMB reported moderate to severe impacts across physical health, mental health, social activities, work, and relationships, with key qualitative themes including loss of control and activity restriction, menstrual stigma and relationship challenges, mental well-being decline, and a need for support. The authors note a major limitation of small sample size (n=33) and reliance on self-reported experience gathered through online recruitment. Relevance to endometriosis: the paper is included because it addresses menstrual-related pelvic bleeding symptoms (HMB) that overlap with endometriosis-related heavy bleeding, though it does not explicitly discuss endometriosis or adenomyosis.

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Abstract

BACKGROUND: Heavy menstrual bleeding (HMB) is a prevalent condition that significantly impacts women of reproductive age. Despite its widespread effect, the multifaceted nature and broader implications of HMB remain underexplored in the UK. AIM: This study aims to investigate the impact of HMB on women's quality of life, focusing on physical, emotional, and social consequences. METHOD: A mixed-methods survey was developed using the biopsychosocial model and made available online in June 2024. Social media adverts were used to recruit women in the UK with current or past experience of self-reported HMB. Quantitative data was analysed using descriptive statistics, while thematic analysis was applied to the qualitative responses. Ethical approval was granted from University College London Ethics Committee. RESULTS: Thirty-three women completed the survey. Most participants rated the impact of HMB on their physical health as moderate to severe. Similar trends were observed for mental health, social activities, work, and relationships. Thematic analysis identified four key themes: 1) lack of control and restriction of activities; 2) social stigma and relationship challenges; 3) the toll on mental well-being; and 4) the need for support. CONCLUSION: This study highlights the pervasive impact of HMB, exacerbated by menstrual stigma, which worsens emotional distress, social isolation, and work-related challenges. These findings stress the need for improved healthcare strategies, increased awareness, and enhanced support systems in professional and social contexts. Future research should explore the economic burden and career-related implications of HMB to inform better healthcare and social policies.
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Abstract

Background Heavy menstrual bleeding (HMB) is a prevalent condition that significantly impacts women of reproductive age. Despite its widespread effect, the multifaceted nature and broader implications of HMB remain underexplored in the UK. Aim This study aims to investigate the impact of HMB on women’s quality of life, focusing on physical, emotional, and social consequences.

Method

A mixed-methods survey was developed using the biopsychosocial model and made available online in June 2024. Social media adverts were used to recruit women in the UK with current or past experience of self-reported HMB. Quantitative data was analysed using descriptive statistics, while thematic analysis was applied to the qualitative responses. Ethical approval was granted from University College London Ethics Committee.

Results

Thirty-three women completed the survey. Most participants rated the impact of HMB on their physical health as moderate to severe. Similar trends were observed for mental health, social activities, work, and relationships. Thematic analysis identified four key themes: 1) lack of control and restriction of activities; 2) social stigma and relationship challenges; 3) the toll on mental well-being; and 4) the need for support.

Conclusion

This study highlights the pervasive impact of HMB, exacerbated by menstrual stigma, which worsens emotional distress, social isolation, and work-related challenges. These findings stress the need for improved healthcare strategies, increased awareness, and enhanced support systems in professional and social contexts. Future research should explore the economic burden and career-related implications of HMB to inform better healthcare and social policies. - © British Journal of General Practice 2025

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