月经过多对生活质量的影响：一项混合方法调查研究
这项英国混合方法在线调查纳入105例有月经过多经历且出生时被指定为女性的成人。研究同时收集定量多选题与开放式定性资料，描述月经过多对躯体、心理、社会参与和性关系的多维影响。结果显示月经过多与多领域生活质量损害相关，影响远超出血量本身。
要点
- 月经过多可造成躯体、心理、社会参与和性关系多维度生活质量损害。
- 管理应注重整体和以患者为中心，包括及时检查、适当药物治疗及心理社会支持。
- 患者可能存在贫血相关症状、夜间中断和漏血焦虑，需系统性评估。
核心结论
- 在参与者中，月经过多与多领域生活质量损害相关，影响远超出血量本身。
- 结果提示需要整体、以患者为中心的管理，包括及时检查、适当药物治疗和心理社会支持。
研究设计与样本
- 采用混合方法在线调查，由定量多选题和开放式问题组成。
- 纳入105例英国全国范围内有月经过多经历的出生时被指定为女性成人。
- 2024年6月至7月通过社交媒体、月经健康慈善机构及Katie's Team和Co-Production Collective网络招募。
- 定性资料采用主题分析归纳，定量资料进行描述性总结，结果进行整合。
主要发现
- 多数参与者报告出血持续≥6天，月经过多持续时间长且在生育早期开始。
- 83%报告躯体健康受到严重或极严重影响，73%报告心理健康受到严重或极严重影响。
- 83%报告社会参与受到严重或极严重影响，59%报告性关系受到严重或极严重影响。
- 定性发现包括明显疲劳、与贫血相符症状、疼痛、认知困难和夜间中断。
- 参与者普遍存在漏血焦虑、职业或学业轨迹改变、亲密关系与其他人际关系受损。
临床怎么用
- 对月经过多患者应全面评估躯体、心理、社会参与和性关系方面的影响。
- 管理应包括及时调查、适当药物干预和心理社会支持，而非仅关注出血量。
- 临床中应筛查贫血相关症状、睡眠中断、漏血焦虑及社交受限。
局限性
- 研究为在线调查，样本为105例，可能存在选择偏倚。
- 结果来自自报数据，缺乏客观出血量和血红蛋白等指标。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
原文
ABSTRACT Objective To examine the physical, psychological, social, and functional impact of heavy menstrual bleeding (HMB) using a mixed-methods approach. Design Mixed-methods online survey. Population A UK-wide sample of adults assigned female at birth with lived experience of HMB. Participants were recruited between June and July 2024 via social media, menstrual-health charities and the Katie's Team and Co-Production Collective networks. Methods Participants completed an online questionnaire comprising multiple-choice and open-ended items. Qualitative data were analysed inductively using thematic analysis and quantitative data were summarised descriptively. Findings were integrated to understand the multi-dimensional impact of HMB. Patient and public involvement informed survey development. Main Outcome Measures Menstrual cycle characteristics; self-reported physical, psychological, social, and functional impacts of HMB. Results 105 participants were included. Most reported bleeding lasting ≥ 6 days and long-standing HMB beginning early in their reproductive lives. Severe or very severe impact was reported across physical health (83%), mental health (73%), social participation (83%), and sexual relationships (59%). Qualitative findings highlighted profound fatigue, symptoms consistent with anaemia, pain, cognitive difficulties, and night-time disruption. Participants described pervasive anxiety regarding leakage, altered career or study trajectories, and adverse effects on intimacy and relationships. Many structured daily routines around access to toilets and sanitary protection. Experiences of stigma and unmet healthcare needs were common. Conclusions Among participants, HMB was associated with quality of life impairment across multiple domains, extending far beyond bleeding volume. These findings underscore the importance of holistic, patient-centred management, including timely investigation, appropriate medical therapy, and psychosocial support.
引用
- BJOG：The Impact of Heavy Menstrual Bleeding on Quality of Life: A Mixed‐Methods Survey Study
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。