Heavy menstrual bleeding – how education and technology could transform treatment

Improving awareness, access and continued technological innovation is crucial to better support women and clinicians, says Tim Simpson.

Heavy menstrual bleeding, also known as menorrhagia, is a condition one in five women suffer with. However, despite this being one of the most common gynaecological conditions there is low awareness of the condition.

It is defined as needing to change your pad or tampon every one to two hours, a period of longer than seven days and doubling up on sanitary protection. It can also mean you bleed through to clothes or bedding.

Many women’s lives are negatively impacted by heavy menstrual bleeding (HMB), while they are often faced by a long and frustrating journey to diagnosis and treatment.

Increasing  awareness of the condition among women and clinicians, ensuring access to medical help, and applying technology to improve the treatment pathway are steps that should be taken to improve this.

Debilitating daily impact

Our research shows that for women living with it, HMB has a profound impact on their daily life, both physically and mentally.

As many as 45 per cent of women have had to stop daily activities, one in three (32 per cent) are less productive at work and 29 per cent do not even leave the house as a result of HMB.

Many women are living with crippling pain with nearly four in 10 (38 per cent) reporting their condition as very painful and 28 per cent of women reporting a negative impact on their mental health.

Overlooked and under diagnosed

Raising awareness is crucial to empower women to seek help and ensure they can recognise the symptoms of HMB and know it is something that can be managed and treated, not just endured.

In addition, three in five women (59 per cent) believe they did not receive enough education about menstruation whilst at school.

Given most women experience their first menstrual cycle while still in school, it would seem important to improve this, so women grow up with a better understanding of what could be considered abnormal.

Despite many women being impacted, there is still some confusion on symptoms.

Nearly half of women falsely identify bloating (47 per cent) and headaches (43 per cent) as symptoms.

We need to see a public health campaign that reaches as many women as possible to help boost awareness of the condition so more women recognise the symptoms.

Long road to diagnosis

Early and accurate diagnosis is key, but receiving a diagnosis takes considerable time. Under a quarter of women (24 per cent) have received a formal diagnosis from a healthcare professional.

The average time it takes for women to get a diagnosis after first talking to a healthcare professional is 3.3 years.

One way to improve this is to introduce a screening process for HMB and run this when a woman attends primary care for any gynaecological procedure.

This is backed by more than half of women who live with HMB (52 per cent), who believe menstrual health check ups should be part of regular/routine appointments for women.

Technology to transform treatment

HMB is a treatable condition with a range of treatment options. For some the best option may be hormonal or non-hormonal treatment whereas others will opt for surgery.

Traditionally from a surgical perspective, women are offered a hysterectomy. However, there are a variety of options including minimally invasive treatments, depending on what is causing HMB.

For example, hysteroscopy can be used to remove fibroids and polyps. It can also be done in a see & treat setting in outpatients. Meaning women can get diagnosed and treated in one sitting and do not require hospitalisation, which has wide ranging socioeconomic arguments to support.

Fluid management is a key element to successful hysteroscopy. Advancements in fluid management mean healthcare professionals can now manage this automatically rather than manually.

This is crucial for both patient safety and to support healthcare professionals to run a more efficient surgery.

Unfortunately, there is a postcode lottery when it comes to accessing these types of services in an outpatient setting.

We’d like to see every hospital in the UK be able to offer an outpatient see & treat hysteroscopy service.

Providing women with a less invasive treatment pathway and helping healthcare professionals tackle the backlog of elective care.

Working together

It goes without saying, improving awareness, access and continued technological innovation is crucial to better support women and clinicians.

HMB is yet another area of women’s health that is currently overlooked, but applying the same ambition and collaboration, great developments can be made.

This is more important than ever as the UK faces an elective care backlog crisis, with more than half a million women in the UK currently on waiting lists for gynaecological appointments.

As highlighted in our recent report ‘The right patients, the right setting, the right clinicians’, which brought together key experts across menstrual health, we need to work collaboratively to drive this urgent change, and I look forward to continuing our work in this critical space.

Tim Simpson is the general manager at Hologic UK & Ireland.