What do women in rural Bareilly think about postmenopausal bleeding? A mixed-method study

Abstract

Background: Perception of women about postmenopausal bleeding (PMB) varies across different social, cultural and economic settings and it may have a greater influence on their treatment seeking behavior. Postmenopausal bleeding (PMB) is an alarming sign of a probable underlying cervical/endometrial cancer. Objectives were to explore the perceptions of causes and treatment of postmenopausal bleeding among menopausal women and to quantify the various perceived reasons for PMB.Methods: It was a sequential exploratory mixed methods study design, where two group interviews were conducted with purposively selected eight postmenopausal women (>30 years of age) in each group (qualitative phase) followed by a house-to-house survey among a representative sample of 1530 postmenopausal women (quantitative phase). The qualitative data was subjected to thematic analysis and quantitative data was analysed using descriptive statistics in Epi infoTM 7.Results: Women perceived problems in uterus, cancer, improved nutrition, old age, sudden liberation of stagnant blood from uterus body nature as causes for PMB. Lack of seriousness about PMB, stigma, shyness and lack of resources were stated as barriers for treatment of PMB. Among 1530 women surveyed, 40.8% of them didn’t know the cause for PMB. Problem in uterus, cancer and sudden liberation of stagnant blood from uterus were stated as reasons by 17.6%, 16.8% and 8.7% of respondents respectively. About 15.8% and 13.2% of women stated improved nutrition and old age respectively as cause for PMB.Conclusions: Most of the women did not know the reason for PMB and its awareness is crucial for better uptake of screening to detect any underlying pathology at an early stage.