Women’s preferences for the levonorgestrel intrauterine system versus endometrial ablation for heavy menstrual bleeding

Brink, Marian van den; Beelen, Pleun; Herman, Malou C.; Claassen, Nathalie J J; Bongers, Marlies Y.; Geomini, Peggy M.A.J.; Steeg, Jan Willem van der; Wijngaard, Lotte van den; Wely, Madelon van

doi:10.1016/j.ejogrb.2018.06.020

Cited by 13 publications

(6 citation statements)

References 23 publications

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“…This nding is also in line with the results of van den Brink et al (2018) (17). They studied women's preferences for treatment of HMB and concluded that the presence of hormones, the (ire)reversibility of the treatment and the effect on irregular bleeding were important in making a decision regarding treatment options (17). In our study, participants mentioned the presence of hormones as a reason for not choosing a speci c treatment.…”

Section: Discussionsupporting

confidence: 91%

“…Therefore, many participants favored the least invasive and least risky treatment. This nding is also in line with the results of van den Brink et al (2018) (17). They studied women's preferences for treatment of HMB and concluded that the presence of hormones, the (ire)reversibility of the treatment and the effect on irregular bleeding were important in making a decision regarding treatment options (17).…”

Section: Discussionsupporting

confidence: 78%

“…The interviews revealed some participants had a negative connotation towards hormone-containing treatment, mainly due to the perception of administered hormones not being natural. The study of den Brink et al con rms this nding, as further explained below (17).…”

Section: Discussionmentioning

confidence: 65%

“…According to the research of Skea (2004), 75% of the women who underwent a hysterectomy for HMB preferred to make the decision together with their physician. Four percent of the women preferred the physician to make the decision, and 2% wanted to make their own decision (17).…”

Section: Discussionmentioning

confidence: 99%

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Patients’ motives and considerations on treatment decision-making for heavy menstrual bleeding: a qualitative study

Oderkerk,

Singotani,

Zuidema

et al. 2024

Preprint

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Background Several treatment modalities for heavy menstrual bleeding are available. However, many women report being unsatisfied in their search for an appropriate and effective treatment. The aim of this study is to gain insights in the experienced impact of HMB and the motives and considerations of women during the decision-making process for different treatment options for heavy menstrual bleeding. Methods An interpretative qualitative study was performed, using in-depth interviews. In total, 14 semi-structured interviews were conducted with patients who consulted a physician for treatment of heavy menstrual bleeding. Participants were recruited via the Dutch Patient Federation (N = 10) or via the outpatient clinic in the Máxima Medical Centre (N = 4). The interviews were conducted by phone or online between February 2020 and March 2021. In the interviews three topics were addressed: 1) participants experience with heavy menstrual bleeding, 2) patient experience with treatment journey and 3) elaborating on alternative treatments for heavy menstrual bleeding. A thematic content analysis was conducted. Results Fourteen participants aged between 30 and 59 years old were interviewed. Three main themes emerged; “Considerations in taking the first step to seek help”, “Various sources of information can contribute, confuse or frighten decision-making process” and “A physician’s support and understanding is needed to guide the decision-making process”. Conclusion Our results show that women's considerations and decision making strongly depend on the obtained information and experience, the relationship with the physician, the influence of the social environment, the pre-visit expectations/ desires, the fear of treatment complications and uncertainty of the effect of the treatment. It’s a physicians roll to create a trusting and open atmosphere during consultation. Patient-centered communication is helpful to share knowledge, and gain inside into a patient’s hopes, fears and worries.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

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Patients’ motives and considerations on treatment decision-making for heavy menstrual bleeding: a qualitative study

Oderkerk,

Singotani,

Zuidema

et al. 2024

Preprint

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“…Endometrial ablation as a treatment option for heavy menstrual bleeding has gained popularity since techniques have improved over the last two decades 1 2. However, due to amenorrheic menstrual patterns and the development of intrauterine and intracervical adhesions, questions have risen about difficulties of diagnosing endometrial pathology after ablation.…”

Section: Introductionmentioning

confidence: 99%

Endometrial cancer after endometrial ablation: a systematic review

Oderkerk

Kar

Cornel

et al. 2022

Int J Gynecol Cancer

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ObjectiveTo investigate whether a previously performed endometrial ablation is associated with the development and diagnosis of endometrial cancer.MethodsFirst, a systematic review was performed of the articles reporting the incidence of endometrial cancer in patients treated with endometrial ablation. Second, a systematic review was performed to identify all individual cases of endometrial cancer after ablation to evaluate presenting symptoms, diagnostic work-up, potential risk factors, and the type and stage of the endometrial cancer. A systematic search was performed, using Medline, EMBASE, and the Cochrane Library databases, from inception through February 24, 2022.ResultsBased on 11 included studies, the incidence of endometrial cancer in a population of 29 102 patients with a prior endometrial ablation ranged from 0.0% to 1.6%.A total of 38 cases of endometrial cancer after ablation were identified. In 71% of cases (17 of 24 cases), vaginal bleeding was the first presenting symptom. With transvaginal ultrasound it was possible to identify and measure the endometrial thickness in eight cases. Endometrium sampling was successful in 16 of 18 described cases (89%). In 18 of 20 cases (90%) pathologic examination showed early-stage endometrioid adenocarcinoma (International Federation of Gynecology and Obstetrics stage I).ConclusionPrevious endometrial ablation is not associated with the development of endometrial cancer. Diagnostic work-up is not impeded by previous endometrial ablation. In addition, endometrial cancers after endometrial ablation are not detected at an advanced stage.

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Hevig menstrueel bloedverlies en myomen

Wijs¹

2019

Praktische Huisartsgeneeskunde

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Women’s preferences for the levonorgestrel intrauterine system versus endometrial ablation for heavy menstrual bleeding

Cited by 13 publications

References 23 publications

Patients’ motives and considerations on treatment decision-making for heavy menstrual bleeding: a qualitative study

Patients’ motives and considerations on treatment decision-making for heavy menstrual bleeding: a qualitative study

Endometrial cancer after endometrial ablation: a systematic review

Hevig menstrueel bloedverlies en myomen

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