title: Increased vaginal bleeding and psychological distress: a longitudinal study of their relationship in the community.
abstract: OBJECTIVE
  To explore the temporal relationship between the development of self-reported symptoms of vaginal bleeding and the development of psychological distress among women in the community.
  
  
  METHODS
  Prospective cohort study using postal surveys at baseline and at 6 and 12 months.
  
  
  METHODS
  An urban four-partner general practice with 10000 registered patients.
  
  
  METHODS
  All women aged 18-54 years on the practice age-sex register.
  
  
  METHODS
  Baseline postal questionnaire with follow up questionnaires sent at 6 and 12 months.
  
  
  METHODS
  The associations between the development of heavy periods and psychological distress.
  
  
  RESULTS
  Two thousand and four hundred and thirty-five baseline questionnaires were sent out with an initial response rate of 76%. One thousand and five hundred and thirteen women (62%) responded to all three questionnaires. Women with psychological distress at baseline were more likely to develop heavy periods 6 months later than women without distress (adjusted odds ratio 1.87, 95% CI 1.15, 3.02). Women with heavy periods at baseline were no more likely to develop psychological distress 6 months later than women with non-heavy periods (adjusted odds ratio 1.09, 95% CI 0.73, 1.63). Similar findings existed with respect to intermenstrual bleeding and postcoital bleeding. Results of the 12-month analysis were similar.
  
  
  CONCLUSIONS
  In the community, psychological distress appears to influence the future self-reporting of heavy periods and other symptoms of vaginal bleeding.
authors.affiliation: Primary Care Sciences Research Centre, Keele University, Staffordshire, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Shapley
authors.forename: Kelvin
authors.initials: K
authors.lastname: Jordan
authors.forename: Peter R
authors.initials: PR
authors.lastname: Croft
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003267:Contraception; D005194:Family Practice; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008595:Menorrhagia / Q000523:psychology*; D008875:Middle Aged; D011446:Prospective Studies; D013315:Stress, Psychological / Q000150:complications*; D011795:Surveys and Questionnaires; D014504:Urban Health