First-line management of menorrhagia: Findings from a survey of general practitioners in Forth Valley

This study was undertaken to determine local GPs' current management of men orrhagia, prior to the release of the Royal College of Obstetricians and Gy naecologists' (RCOG) guideline on the initial management of menorrhagia. A postal questionnaire was sent to 204 GPs in the Forth Valley area. An 84% ( n = 173) response rate was recorded Responses were compared with RCOG guide line recommendations after its release. Fifty-two percent of respondents me asured a full blood count and 56% performed a pelvic examination. Two third s of GPs chose the recommended treatments (mefenamic acid or tranexamic aci d) as their first or second choice of treatment in women not requiring cont raception. One third chose cyclical progestogens. Only 10% of GPs selected an ineffective treatment (cyclical progestogens) as their first or second c hoice of treatment in women requiring contraception. This survey demonstrat es that the majority of GPs are already prescribing the treatments recommen ded in the RCOG guidelines. There is a need for education amongst a minorit y to improve their practice. Half of the GPs reported compliance with the r ecommended investigations of full blood count and pelvic examination. The p oint at which these investigations are performed in the initial management of menorrhagia may need further discussion between primary and secondary ca re clinicians to clarify their purpose.