Communication about heavy menstrual bleeding; is this the last taboo subject?

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The problem

Heavy menstrual bleeding (HMB) is known to have a multifaceted impact on women’s quality of life. Previous research has suggested that menstruation is considered to be a taboo subject. This longitudinal qualitative study, nested within a large randomized controlled trial (The ECLIPSE Trial, aimed to explore women’s experiences of medical treatment for HMB, exploring communication about HMB between women and; their families, partners, and health professionals.

The approach

Twenty seven women were purposefully selected and interviewed twice during their experience of medical treatment for heavy menstrual bleeding. Data was collated and analysed using a grounded theory approach with this methodology well suited to the exploration of a complex condition of unknown aetiology and multifaceted impact.


The majority of women in this study had very little information about menstruation at first menarche. Where information was available it often came from older sisters or peers. Feelings of fear and isolation at menarche and negative views on menstruation into adulthood were prevalent. Women attempted to maintain societal norms of silence and concealment of menstruation, but felt ‘failure’ if menstrual bleeding became apparent due to HMB. HMB was reported to have a huge impact on women’s self esteem, sexual activity and therefore on their intimate relationships. Within medical consultations women found communication about HMB challenging particularly when discussing sexuality and future fertility. Factors that improved communication included the gender and expertise of the health professional and the primary care setting.


Communication about HMB remains challenging for women particularly in relation to sexuality. The powerful societal need to remain silent and conceal menstrual difficulties needs to be recognized by health professionals in order to facilitate open conversations during consultations for HMB.


  • Gail Prileszky, New Zealand Institute of Community Health Care, Christchurch, New Zealand
  • Joe Kai, New Zealand Institute of Community Health Care, Christchurch, New Zealand