Clinical Practice Guideline for Abnormal Uterine Bleeding: Hysterectomy versus Alternative Therapy

Wheeler, Thomas L.; Murphy, Miles; Rogers, Rebecca G.; Gala, Rajiv B.; Washington, Blair B.; Bradley, Linda D.; Uhlig, Katrin

doi:10.1016/j.jmig.2011.10.001

Cited by 19 publications

(4 citation statements)

References 32 publications

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“…Most of the included guidelines (20/22) provided recommendations on the diagnosis and management of ID and/or IDA. Only two of the included guidelines provided no guidance in relation to ID and IDA; both focused solely on the choice of treatment modality to correct abnormal uterine bleeding, and did not cover the full care continuum [48,49].…”

Section: Guideline Recommendations For Diagnosis and Management Of Idmentioning

confidence: 99%

A Review of Clinical Guidelines on the Management of Iron Deficiency and Iron-Deficiency Anemia in Women with Heavy Menstrual Bleeding

Mansour¹,

Hofmann

Gemzell‐Danielsson

2020

Adv Ther

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Introduction: Up to one-third of women of reproductive age experience heavy menstrual bleeding (HMB). HMB can give rise to iron deficiency (ID) and, in severe cases, iron-deficiency anemia (IDA). Aim: To review current guidelines for the management of HMB, with regards to screening for anemia, measuring iron levels, and treating ID/IDA with iron replacement therapy and noniron-based treatments. Methods: The literature was searched for English-language guidelines relating to HMB published between 2010 and 2020, using the PubMed database, web searching, and retrieval of clinical guidelines from professional societies.

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Section: Guideline Recommendations For Diagnosis and Management Of Idmentioning

confidence: 99%

A Review of Clinical Guidelines on the Management of Iron Deficiency and Iron-Deficiency Anemia in Women with Heavy Menstrual Bleeding

Mansour¹,

Hofmann

Gemzell‐Danielsson

2020

Adv Ther

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“…Included were nine RCTs, comparing endometrial ablation (EA), the levonorogestrel intrauterine system (Lng-IUS), and systematically administered medical therapy (different types of estrogen and/or progesterone preparations). Based on this review, clinical practice guidelines were issued, with recommendations graded either strong or weak [ 40 •]. Concerning sexual function, recommendations were weak and no advantage of any of these methods over hysterectomy was found.…”

Section: Alternative Treatments Compared To Hysterectomymentioning

confidence: 99%

Effects of Hysterectomy on Sexual Function

Lonnée-Hoffmann

Pinas

2014

Curr Sex Health Rep

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Hysterectomy remains the most common major gynecological surgery. Postoperative sexual function is a concern for many women and their partners. In this respect, a beneficial effect of hysterectomy for benign disease independent of surgical techniques or removal of the cervix has been demonstrated in the past decade by the majority of studies. For about 20 % of women, deteriorated sexual function has been reported and current research is attempting to identify mechanisms and predictive factors explaining these postoperative changes. Alternative treatments of benign uterine disorders or uterus preserving surgery for genital prolapse appeared to have similar outcomes in terms of sexual function. Concomitant oophorectomy had negative effects on sexual function and long-term health, particularly in premenopausal women. This may not be reversed by estrogen replacement. Hysterectomy performed for malignancy had a detrimental effect on sexual function. Individualized risk assessment and information should be aimed at during preoperative decision making.

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“…Choosing the ''best'' treatment for AUB for the individual patient involves shared decision-making and strong consideration of patient values and preferences. 22 Given women with AUB are accessing care, optimizing their medical care by developing more effective treatment strategies (better options, optimizing use of the most effective available options) could positively impact the quality of life of a substantial population of women and lead to more efficient use of health resources. Our study had several limitations.…”

Section: 4mentioning

confidence: 99%

Abnormal Uterine Bleeding, Health Status, and Usual Source of Medical Care: Analyses Using the Medical Expenditures Panel Survey

Matteson

Raker

Clark

et al. 2013

Journal of Women's Health

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Background: Traditionally, research on abnormal uterine bleeding (AUB) focused on measured menstrual blood loss. However, the main burden of this symptom from the patient perspective is its impact on quality of life. Better describing the demographic characteristics, quality of life, and utilization of medical care of women with AUB could assist with health resource planning for this population. Methods: We analyzed data from the Medical Expenditures Panel Survey from 2002 to 2010. AUB was identified by International Classification of Diseases, ninth edition (ICD-9) code group 626, disorders of menstruation and other abnormal bleeding from the female genital tract. Health-related quality of life was assessed by the Shortform 12 Health Survey (SF-12, QualityMetric) physical and mental component summary scores (PCS and MCS). Poorer health-related quality of life was defined as PCS or MCS < 50. Odds ratios (OR) and 95% confidence intervals (CI) for the association of AUB with poorer SF-12 scores and having a usual source of care were estimated by multivariable logistic regression models. Results: Data analyzed represented an annual average of 56.2 million nonpregnant women between ages 18 and 50 years. We estimate that 1.4 million women per year (95% CI: 1.3-1.5 million) reported AUB. Women with AUB were more likely to be younger, Caucasian, and obese than women without AUB. Compared to women without AUB, women with AUB had greater odds of a poorer PCS score (OR = 1.30, 95% CI: 1.10-1.55), a poorer MCS score (OR = 1.28, 95% CI: 1.10-1.51), and a usual source of care (OR = 1.85, 95% CI: 1.44-2.38). Conclusions: AUB is associated with diminished physical and mental health status and having a usual source of medical care.

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Clinical Practice Guideline for Abnormal Uterine Bleeding: Hysterectomy versus Alternative Therapy

Cited by 19 publications

References 32 publications

A Review of Clinical Guidelines on the Management of Iron Deficiency and Iron-Deficiency Anemia in Women with Heavy Menstrual Bleeding

A Review of Clinical Guidelines on the Management of Iron Deficiency and Iron-Deficiency Anemia in Women with Heavy Menstrual Bleeding

Effects of Hysterectomy on Sexual Function

Abnormal Uterine Bleeding, Health Status, and Usual Source of Medical Care: Analyses Using the Medical Expenditures Panel Survey

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