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).