Heavy menstrual bleeding — A guide for GPs

Thanks Campbell for that fantastic introduction.

Thanks HealthCert as well and also to Bayer for allowing us to do this tonight.

As Campbell said, we have CPD accreditation and there is also further education that's available for you and I'd encourage you to take advantage of those free education courses for GPs.

They're very valuable.

So tonight we're learning about heavy menstrual bleeding and how we manage that in general practice across the age span.

We'll be applying the Palm-Cohen classification framework to structure assessment of abnormal urine bleeding and we'll also be discussing and consulting with patients how we frame the patient based on the Australian clinical care standard.

That includes history examination and investigations.

We'll be talking about medical management pathways and breaking that down into first line options and then when to refer.

Counselling patients is also going to be a large part of what we do in general practice in terms of patients options.

and things for them to consider individually.

The shared decision-making framework should be used always when discussing patients' options in general practice.

So what should we change in our consultations? Basically, we need to recognise, act and counsel.

So we're identifying heavy menstrual bleeding from its impact, assessing the causes and detecting iron deficiency.

This is the initial part of the consultation when a patient comes and wanting to discuss this particular symptom.

We need to work out, is it pathological? Is it not? How do we investigate this? We also want to be able to safely start symptom relief.

at the first presentation while we progress with the targeted investigations.

And then counseling involves explaining treatment options and how we're going to plan the management for that patient through their pathway.

So who does HMB affect? 25% of women of reproductive age experience heavy menstrual bleeding and many women consider their experience as normal.

So it's estimated that around 50% of women don't seek medical care despite the debilitating impact on their daily life.

Some of the factors that prevent women from seeking care include taboos and stigma that can be associated with menstrual issues.

So we just don't talk about women's business.

normalizing heavy menstrual bleeding by society and healthcare providers.

It's not really that bad, is it? And also not having a trusted therapeutic relationship with the general practitioner, male or female, that the patient can discuss these sensitive issues with.

So it's often worthwhile as you're doing this screening, as we're looking at different stages of patients' lives, And also when, you know, repeat scripts for the pill or, you know, around childbirth and reproductive issues, just about asking, you know, do you think you have heavy periods? You know, what does it stop you from doing? So that's a good way to open the conversation so that the patient can feel that they'll be heard, they'll be listened to.

So defining HMB is by impact, not milliliters, not number of pads.