Lunardi Rocha Ana Luiza, Cristina França Ferreira Márcia, Mara Lamaita Rívia, Batista Cândido Eduardo, Mendonça Carneiro Márcia, Lopes da Silva-Filho Agnaldo
a Department of Obstetrics and Gynaecology , Federal University of Minas Gerais , Belo Horizonte , Brazil.
Eur J Contracept Reprod Health Care. 2018 Aug;23(4):288-294. doi: 10.1080/13625187.2018.1483018. Epub 2018 Jun 25.
This study sought to assess the perceptions of health care practitioners (HCPs) regarding heavy menstrual bleeding (HMB).
We developed an online survey for HCPs administered in 10 countries (Brazil, Canada, China, France, Germany, Korea, Russia, Spain, UK and USA), in order to assess their perceptions regarding HMB.
We received 1032 responses. Most HCPs considered more than 7 days of bleeding abnormal. There was a significant difference in the definition of HMB between countries (p < .001). Most HCPs measured menstrual blood loss by the number of sanitary pads or tampons needed, followed by the impact on patients' daily activities. The majority of HMB patients (61%) were diagnosed as having a non-structural disorder with no causative identifiable coagulopathy. Patient acceptance and compliance were each relevant for the treatment decisions of half of the HCPs. Treatment options for idiopathic HMB featured mainly oral contraceptives and the levonorgestrel-releasing intrauterine system. Surgery was mentioned as a treatment option for idiopathic HMB by 44% of HCPs.
The definition of HMB and HCP perceptions of HMB regarding diagnostic and therapeutic issues varied between countries. Surgery was mentioned as a treatment for idiopathic HMB by nearly half of HCPs. Clinician education is greatly needed to improve the management of women with HMB.
本研究旨在评估医疗保健从业者（HCPs）对月经过多（HMB）的看法。
我们为10个国家（巴西、加拿大、中国、法国、德国、韩国、俄罗斯、西班牙、英国和美国）的HCPs开展了一项在线调查，以评估他们对HMB的看法。
我们收到了1032份回复。大多数HCPs认为出血超过7天属于异常。各国之间HMB的定义存在显著差异（p < 0.001）。大多数HCPs通过所需卫生巾或卫生棉条的数量来衡量月经量，其次是对患者日常活动的影响。大多数HMB患者（61%）被诊断为患有非结构性疾病，且不存在可识别的凝血病因。患者的接受度和依从性对一半的HCPs的治疗决策都很重要。特发性HMB的治疗选择主要包括口服避孕药和左炔诺孕酮宫内节育系统。44%的HCPs提到手术是特发性HMB的一种治疗选择。
各国之间HMB的定义以及HCPs对HMB在诊断和治疗问题上的看法存在差异。近一半的HCPs提到手术是特发性HMB的一种治疗方法。亟需对临床医生进行培训，以改善对HMB女性的管理。
