Questioning our questions: do frequently asked questions adequately cover the aspects of women's lives most affected by abnormal uterine bleeding? Opinions of women with abnormal uterine bleeding participating in focus group discussions

Abstract

Objectives of this article are: (1) to explore the effects on women's lives by heavy or irregular menstrual bleeding; and (2) to examine whether aspects of women's lives most affected by heavy or irregular menstrual bleeding were adequately addressed by questions that are frequently used in clinical encounters and available questionnaires. We conducted four focus group sessions with a total of 25 English-speaking women who had reported abnormal uterine bleeding. Discussions included open-ended questions that pertained to bleeding, aspects of life affected by bleeding, and questions frequently used in clinical settings about bleeding and quality of life. We identified five themes that reflected how women's lives were affected by heavy or irregular menstrual bleeding: irritation/inconvenience, bleeding-associated pain, self-consciousness about odor, social embarrassment, and ritual-like behavior. Although women responded that the frequently used questions about bleeding and quality of life were important, they felt that the questions failed to go into enough depth to adequately characterize their experiences. Based on the themes identified in our focus group sessions, clinicians and researchers may need to change the questions used to capture "patient experience" with abnormal uterine bleeding more accurately.

FIGURE 1

A model for quality of life relative to heavy and/or irregular menstrual bleeding. Shaded—aspects of bleeding and life covered in typical questions used to clinically assess women with heavy and/or irregular menstrual bleeding. Unshaded—aspects of bleeding and life NOT adequately covered in typical questions used to clinically assess women with heavy and/or irregular menstrual bleeding.