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Title: Psychiatric symptomatology and menorrhagia : psychiatric morbidity and menstrual loss in women receiving endometrial ablation for heavy periods
Author: Wright, John Barry Debenham
ISNI:       0000 0001 3573 0239
Awarding Body: University of London
Current Institution: University College London (University of London)
Date of Award: 2000
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Objective: To explore the relation between pre-operative psychiatric morbidity and actual menstrual loss, and psychiatric outcome after endometrial ablation for heavy periods. Design: Prospective cohort. Setting: Leeds General Infirmary. Subjects: Women presenting consecutively in the gynaecology out-patient department awaiting endometrial ablation for heavy periods. Main outcome measure: Psychiatric status at fifteen months post-operatively using the semi-structured interview, Present State Examination. Results: 120 women were eligible for study. 12 declined and a further 16 did not proceed past the initial stages for a variety of reasons (including very low actual menstrual loss, organic pathology requiring alternative treatment and failed clinic attendance). 92 women received endometrial ablation and were followed up. 75 women agreed to collect menstrual sanitary towels and tampons. 49% had an actual loss of less than 80 millilitres (the cut-off recognised by gynaecologists as representing heavy loss). 24% had less than 40 millilitres. Of the original 108 women presenting, 58% had significant psychiatric morbidity. Most of this morbidity involved symptoms of depression and anxiety. Of seven women counselled from surgery because of low actual loss, 6 had significant psychiatric morbidity. Of the 14 women who were psychiatric 'cases' before and after operation 9 of them had actual losses that were less than 80 millilitres. Psychiatric morbidity fell post-operatively to 21.8%. When looking at different sub-groups, women with the best outcome (6% post-operative psychiatric morbidity) are those with genuine heavy loss and no pre-operative psychiatric morbidity. Those who fare worst (37% post-operative psychiatric morbidity) are women with preoperative psychiatric morbidity and low actual menstrual loss. Conclusions: Psychiatric status and actual menstrual loss should be considered when exploring the possibility of surgery for women with heavy periods.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Medicine