title: Correlates of women's preferences for treatment of heavy menstrual bleeding.
abstract: This cross-sectional survey investigated factors associated with treatment preferences of women with menorrhagia. Women (n = 474) aged 35-54 years referred to gynaecology out-patient clinics for menorrhagia were mailed a self-administered questionnaire before their first clinic visit. The main outcome measure was treatment preference. Hysterectomy and conservative treatment (combined with no treatment) were favoured equally often. In a multivariate analysis, completed family size (P = 0.003), menstrual pain (P = 0.02), irregular periods (P = 0.03), and higher age (P = 0.04) predicted hysterectomy preference, as did lower education level (P = 0.001), gynaecologist consultations (P = 0.002), and unemployment (P = 0.03). The psychological factors assessed were not associated with treatment preference. In conclusion, rational considerations regarding stage of reproductive life and severity of symptoms were linked to women's treatment preferences. However, education, employment status and use of specialists' services guided women's preferences even more powerfully than menstrual symptoms and burden caused by them. Doctors should pay more attention to motivating women for a trial of conservative treatment since only half of the women reported previous treatment for their menstrual problem.
authors.affiliation: STAKES, National Research and Development Centre for Welfare and Health, PO Box 220, 00531 Helsinki, Finland. sirkuu.vuorma@stakes.fi
authors.forename: Sirkku
authors.initials: S
authors.lastname: Vuorma
authors.forename: Juha
authors.initials: J
authors.lastname: Teperi
authors.forename: Ritva
authors.initials: R
authors.lastname: Hurskainen
authors.forename: Anna-Mari
authors.initials: AM
authors.lastname: Aalto
authors.forename: Pekka
authors.initials: P
authors.lastname: Rissanen
authors.forename: Erkki
authors.initials: E
authors.lastname: Kujansuu
mesh_terms: D000328:Adult; D001294:Attitude to Health; D002755:Choice Behavior; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008595:Menorrhagia / Q000523:psychology / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D011795:Surveys and Questionnaires