Managing Patients with Menorrhagia

Research suggests that most women with menorrhagia remain unaware of the fact that excessive menstruation is a medical condition for which they can seek treatment. Many women think that bleeding heavily for 4 to 5 days or changing their pad every hour is normal—something they have simply learned to live with.

When asked specifically about their menstruation patterns, some menorrhagic women will actually answer that their periods are fine. They may not know that there is a potentially serious underlying problem, that the menorrhagia itself can be treated, or that they can be helped to overcome their embarrassment about discussing their problem.

To coax reticent women into a more complete discussion concerning menorrhagia and to structure an interview to help clarify their values and preferences, some physicians find it helpful to provide their nursing staff with a list of questions to ask each patient during a visit. Share the following list with your staff, and discuss the importance of conducting a structured interview with each patient:

• How often do you get your period?
• How many days does your period last?
• In the first few days of your period, how many tampons and/or pads do you go through in an hour?
• How often do you have to get up at night to change your tampon/pad?
• How often do you find you bleed through your protection, even your clothes?
• How often do you have a lot of blood clots in your flow when you’re menstruating?
• How often are you afraid to leave the house or go out in public when you have your period?
• How often does your menstrual bleeding cause you to avoid social activities, sexual activity, or sports, or cause you to miss work?

Also, some physicians have found that reviewing patient profiles with office staff has helped to identify women who may have menorrhagia, but may not be likely to provide information about it. These cases offer strategic communication tips for helping your more reticent patients open up. Review patient profiles.