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.

Design: Prospective cohort study using postal surveys at baseline and at 6 and 12 months.

Setting: An urban four-partner general practice with 10000 registered patients.

Population: 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.

Main outcome measures: 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.

Conclusion: In the community, psychological distress appears to influence the future self-reporting of heavy periods and other symptoms of vaginal bleeding.