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GPs avoiding over-referral by ignoring menorrhagia advice

GPs are ignoring over-

sensitive Government referral guidelines on menorrhagia, new research has revealed.

Symptom-based guidelines for the detection of gynaecological malignancy could lead to a quadrupling of referrals if implemented fully, the resear-chers claim.

A survey of more than 1,500 women aged 18-54, published in the British Journal of General Practice (May), found that during a year's follow-up a quarter of women had menorrhagia, 17 per cent had intermenstrual bleeding and 6 per cent had postcoital bleeding.

The survey, which used questionnaires based on current clinical guidelines from the Department of Health and the Royal College of Obstetricians and Gynaecologists, consisted of 12 questions designed to elicit causes of bleeding problems.

By examining the results for postcoital bleeding, the researchers found that GPs were not referring women for investigation of warning symptoms and that adhering to guidelines would result in a four-fold increase in the referral rate.

Study co-author Dr Mark Shapley, a GP in Newcastle-under-Lyme, Staffordshire, and a research fellow at Keele University, said: 'Intermenstrual and postcoital bleeding symptoms were so common and gynaecological malignancy is so rare that the guidelines may have no value.

'I think the research base is poor and we need to recognise these are common symptoms and that we need to think about the way they interfere with a woman's life.'

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