Diagnosing menstrual disorders: a qualitative study of the approach of primary care professionals.
- 1 May 2004
- journal article
- Vol. 54 (502), 353-8
Abstract
Menstrual disorders are a common presentation in primary care. Wide variations in management as well as discordance between patient and practitioners in relation to presenting problems have been described. To explore the model of menstrual disorders used by practitioners in practice. Semi-structured interviews with primary care practitioners. One inner London health authority area. Constant comparative analysis. Medical practitioners were critical of the guidance provided by gynaecological definitions and texts. Practitioners put more emphasis on defining normality than on defining disorder. Practitioners used a wide range of criteria to judge their patients' complaints and decide on a course of action. Female practitioners had access to personal and professional experience and used this to develop an understanding of women's complaints. Male practitioners in particular were limited by problems in discussing menstruation in detail. Because of the difficulties in assessing patient history, other non-gynaecological factors such as patient age and consulting behaviour informed practitioners' judgements. This study draws attention to practitioners' problems in using current definitions of menstrual disorders. The combination of unhelpful medical definitions, lack of standards of normality and difficulties in discussing menstruation resulted in individual practitioners making judgements in idiosyncratic ways. In the absence of a useful gynaecological model, practitioners develop individual, often subjective and gendered models to use in practice.Keywords
This publication has 10 references indexed in Scilit:
- Effects of Decision Aids for Menorrhagia on Treatment Choices, Health Outcomes, and CostsJAMA, 2002
- Asking for 'rules of thumb': a way to discover tacit knowledge in general practice.Family Practice, 2002
- GPs' views on their management of sexual dysfunctionFamily Practice, 2001
- Referral for menstrual problems: cross sectional survey of symptoms, reasons for referral, and managementBMJ, 2001
- Management of menorrhagia: an audit of practices in the Anglia menorrhagia education studyBMJ, 2001
- 10-minute consultation: MenorrhagiaBMJ, 2000
- Management of menorrhagia in primary care---impact on referral and hysterectomy: data from the Somerset Morbidity ProjectJournal of Epidemiology and Community Health, 2000
- The myth of objectivity: is medicine moving towards a social constructivist medical paradigm?Family Practice, 2000
- Menorrhagia in general practice — disease or illnessSocial Science & Medicine, 2000
- Choice of treatment for menor rhagiaThe Lancet, 1999