Department of Obstetrics, Gynecology, and Women's Health, University of Otago, Wellington, New Zealand.
Int J Gynaecol Obstet. 2023 Aug;162 Suppl 2:23-28. doi: 10.1002/ijgo.14945.
The symptom of heavy menstrual bleeding (HMB) affects at least a quarter of reproductive-age menstruators. However, given the variance in diagnosing the underlying causes, barriers, and inequity in access to care for HMB, and therefore reporting of HMB, this figure is likely to be a gross underestimate. HMB can have a detrimental impact on quality of life. From the limited reports available it is estimated that around 50%-80% of people with HMB do not seek care for this debilitating symptom, and for those that do, it may take years until the first treatment action. Almost half of those with HMB believe their condition is unworthy of treatment, that there is no treatment available, or that it is "normal". The term "medical gaslighting" has recently been used to describe how healthcare professionals disregard people's symptoms. This has the ensuing effect of negatively compounding self-doubt and embarrassment around menstrual bleeding, creating a cycle of diminished experience inhibiting further seeking of care. There is a scarcity of intervention studies informing increased access to care. Multilevel approaches are needed to increase access to care and support for those with HMB. During the COVID-19 global pandemic, barriers to care access and support for HMB have been exacerbated and, given the significant pressures that this pandemic has placed on healthcare services worldwide, it will take many years to recover. In the meantime, it is crucial to ensure that medically "benign" conditions such as the symptom of HMB are not overlooked.
月经过多（HMB）的症状影响了至少四分之一的育龄期女性。然而，由于诊断潜在原因的差异，以及获得 HMB 治疗的障碍和不平等，因此 HMB 的报告可能被严重低估了。HMB 会对生活质量产生不利影响。根据有限的报告估计，大约 50%-80%的 HMB 患者没有寻求这种使人衰弱的症状的治疗，而对于那些寻求治疗的患者，可能需要数年时间才能采取首次治疗措施。几乎一半的 HMB 患者认为他们的病情不值得治疗，没有可用的治疗方法，或者认为这是“正常”的。最近，人们用“医疗忽视”这个术语来描述医疗保健专业人员如何忽视人们的症状。这继而对月经出血产生负面影响，加剧了自我怀疑和尴尬，形成了一个体验减少的循环，抑制了进一步寻求治疗的机会。缺乏关于增加治疗机会的干预研究。需要采取多层次的方法来增加获得 HMB 治疗和支持的机会。在 COVID-19 全球大流行期间，获得 HMB 治疗和支持的障碍加剧了，由于这场大流行给全球医疗服务带来了巨大压力，需要多年时间才能恢复。在此期间，至关重要的是要确保不会忽视医学上“良性”的情况，如 HMB 症状。
