Diminished symptoms
Many women felt that AUB was not taken seriously, and GPs were often dismissive of their symptoms, as this quote exemplifies:
“I feel like with women’s health I go in and I say ((I am bleeding) and they’re like doesn’t everyone, real dismissive. I definitely find that if I talk to any kind of person about it they’re like oh it happens or it’s your weight. And I’m like I understand it could be- I can understand it could be estrogen or something but I feel like that’s still super dismissive.” Participant 10.
It is also evident from this woman’s shared experience that she had spoken to several GPs (and other non-healthcare practitioners) and also felt that the severity, and impact of, AUB was diminished by them. Furthermore, AUB was also attributed to her weight, with the inference that she carried a responsibility for having AUB. It would appear from the above quote that communication between both parties was not optimal, and that the GP did not understand the severity of her AUB. The feeling of that AUB was diminished by the GPs was further compounded by feelings that the GP did not care, as experienced by another woman:
“The bleeding was still continuing and I was just getting nowhere, and in the end I was anaemic, I collapsed and my GP still wasn’t really bothered.” Participant 14.
All of the women who shared their experiences of AUB had been seeking treatment/resolution, often over many years (Table 2, quote 1), and of significance, women predominantly received only symptomatic treatment (Table 2, quote 2).
It is likely that the suggestion to use hot water bottles (hottie) to help alleviate pain was well-meaning (albeit likely ineffective), and the use of ‘just’ conveys a sense of how they felt dismissed. All women received pain medication, which further added to the feeling and experience that AUB was being diminished (Table 2, quote 3), and any treatment of AUB was not successful for the women in our cohort.
“I’ve been asking for help all the way through and they just keep giving me painkillers and trying the pill” Participant 1.
One patient even described how she received treatment that she did not want, but felt that she had no choice.
“And my last appointment with him was very traumatic ‘cause I went in thinking I don’t want the mirena. And then the mirena was put in…I felt like I was a little bit threatened.” Participant 10.
This experience indicates that the communication was not optimal and a trusted relationship had not been established with the consequence that her right to make an informed choice to receive this treatment was not upheld. The experience that AUB was not being taken seriously, and being given medications for symptomatic relief, was further exacerbated for some women as they didn’t understand the prescriptions they had been given, but took them anyway (Table 2, quote 4). This suggests that women were not enabled to make an informed choice about the course of treatment. A number of women were also prescribed iron tablets and felt that whilst this may have helped their fatigue, it did not help their AUB and in some cases made their bleeding heavier (Table 2, quote 5).