Head of Service of Hematology Hospital General de Valdepenas Valdepenas, Castilla-La Mancha, Spain
Background: Excessive menstrual bleeding (EMB) is a common consultation in primary care. There are various scales to quantify losses and promptly refer to specialized care, however, their use remains limited in routine clinical practice.
Aims: The objective is to describe the semiological tools for referral to Hematology for excessive menstrual bleeding, and their knowledge about quantification scales.
Methods: Prospective, analytical and multicentre study in which 20 family doctors belonging to the Integrated Care Management of Valdepenas (Spain) participated through telephone consultation. Demographic and statistical data were collected.
Results: The median age was 50 years (range: 38-61 years) with parity in both sexes. The median distance between the health center and the hospital was 25 km (range: 1-51 km). The semiological sign that had the highest score among family doctors to refer a patient with EMB was secondary anemia (100%), followed by blood volume loss (90%) and dysmenorrhea (85%). 100% of the sample reported requesting a complete blood count, iron profile and basic hemostasis study within the first consultation, although only 15% would request an initial thyroid profile. Only 5% of the participants use any of the quantification scales described (Highman, PBAC, Philipp) in their usual practice, with the days of bleeding being the most common way of quantifying the EMB (97%).
Conclusion(s): It is essential to increase training on the etiological factors and consequences of EMB, as well as the implementation of validated quantification scales, in order to optimize its management and early referral for study/treatment.
