C14
Postmenopausal bleeding: trends in psychological morbidity
Rachel Tarling, Alison Gale, Paola Dey
1University Of Central Lancashire, Preston, Lancashire, UK, 2Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, UK
Background
Women concern’s about assessment for postmenopausal bleeding (PMB) is under researched. This pilot study was designed to quantify levels of psychological morbidity in these women.
Method
An exploratory questionnaire study involving 55 women over the age of 44. Repeated measures design exploring anxiety (STAI-6), stress (IES) and depression (HADS) at baseline, four days (before hysteroscopy) and twelve weeks.
Results
Fifty-five women were recruited with a mean age of 63 and a mean age of 50 at menopause. Twelve women presented within two weeks of onset of symptoms. Comparisons of women who presented within 3 months of symptom onset, showed those who delayed presentation tended towards lower levels of anxiety and lower mean scores on the intrusion subscale (IES) (difference=5.0,95% CI 1.77 to 8.24). For all women, mean scores of all psychological morbidity measures were high at baseline and 4 days but reduced to population norms within twelve weeks. Women diagnosed with cancer had higher anxiety levels at baseline and 4 days. Those without cancer, who did not undergo hysteroscopy tended to have lower mean scores on the avoidance scale (IES) at baseline and 4 days compared to women who had a hysteroscopy but, surprisingly, these levels did not decrease by twelve weeks (baseline: 9.2 (sd 7.84) vs 12.3 (9.25); 4 days 9.5 (8.42) vs 13.4 (10.53); 90 days: 9.9 (10.04) vs 6.1 (8.58)).
Conclusion
Psychological morbidity is similar to that observed in women undergoing assessment of breast lumps or cervical abnormalities. This pilot study suggests some interesting patterns in subgroups of women with postmenopausal bleeding. A larger longitudinal study is warranted.
