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Keywords:

  • hysterectomy;
  • information;
  • menorrhagia;
  • minimal access surgery;
  • preferences

Background

Menorrhagia represents a major health burden to a large number of women in the UK. A range of medical and surgical treatments is now available for the condition, but each has its own advantages and limitations.

Methods

A postal survey was undertaken of women with apparently uncomplicated menorrhagia referred to one of two NHS hospitals. The aim was to elicit women's preferences for the characteristics of surgical treatment and, specifically, to assess how they traded-off the characteristics of hysterectomy and minimal access surgery.

Results

A total of 221 women returned their questionnaire and were included in the study (59% of those sent out). The characteristics most frequently rated as `very important' were getting back to usual activities as soon as possible (57%), experiencing the least pain and discomfort (46%), spending a short time in hospital (46%) and stopping periods for good (43%). The single characteristic most frequently rated as the most important by women was stopping periods for good (28%). Similar proportions of women preferred abdominal hysterectomy (43%) and endometrial resection (41%) when these were described to them. When asked to think about specific treatments of which they were aware, strong positive (43%) and negative (42%) preferences were indicated. Women's main information source was their general practitioner (70%), but only 44% considered themselves well-informed about menorrhagia and its treatment.

Conclusions

Many women referred to hospital with menorrhagia have conflicting objectives for treatment, feel under-informed about therapies and have not formed treatment preferences. It is important to develop well-structured and accessible sources of information for women and methods to elicit their treatment preferences, and to evaluate the impact of such tools on treatment selection and outcomes.