Biomedical subjects
Miriam Santer
Publications and source records attributed to Miriam Santer.
A Scottish postal survey suggested that the prevailing clinical preoccupation with heavy periods does not reflect the epidemiology of reported symptoms and problems.
OBJECTIVE: To determine the prevalence of self-reported menstrual symptoms and problem periods and explore their relationship with sociodemographic factors, parity, long-standing illness, and hormonal contraceptive use. STUDY DESIGN AND SETTING: Postal questionnaire survey of 4,610 women aged 25-44 registered with 19 general practices in Lothian, Scotland. RESULTS: Among menstruating women, 30% reported heavy periods, a further 5% very heavy periods and 15% severe period pain. Although 39% of women reported either heaviness or pain or both, only 22% reported their periods as a marked or severe problem. Multivariate logistic regression showed that reporting problem periods was associated with long-standing illness, heaviness of bleeding, menstrual pain and inversely associated with hormonal contraceptive use. Reporting problem periods was strongly associated with severe pain (OR = 21, 95% CI = 15-28) and with very heavy loss (OR = 14, 95% CI = 8.0-24). CONCLUSIONS: Reporting heavy or painful periods was common but reporting problem periods was less so. Reporting severe pain was at least as strongly associated with problem periods as very heavy periods and severe pain affected many more women than very heavy periods. Therefore the clinical preoccupation with heavy periods does not reflect the epidemiology of menstrual symptoms or problem.
Women's experiences of Chlamydia screening. Qualitative interviews with women in primary care.
BACKGROUND: Plans are underway to introduce Chlamydia screening in UK primary care. The success of a screening programme depends upon many factors including its acceptability to the population being screened. The experiences of women who have taken part in a pilot study of screening are therefore important in ensuring that services are developed in such a way to maximise health benefits. OBJECTIVES: To explore the experiences of Chlamydia screening among women with both positive and negative results and women who were still waiting for results; to reflect on the implications of their views for primary care based screening programmes. METHODS: Interviews were carried out with twenty women who had participated in a pilot of opportunistic Chlamydia screening carried out in eight general practices in Edinburgh. Four participants had received a positive result, 14 had a negative result and two were still waiting for results. Qualitative analysis was carried out on interview transcripts using the framework approach. RESULTS: Most women saw themselves as at low risk of Chlamydia infection because: it was not perceived as a common infection (many had never heard of it before); they felt that their sexual history did not put them at risk; or because they had no symptoms (although Chlamydia is frequently asymptomatic). Women interviewed welcomed the offer of Chlamydia screening because of the importance of preventing infertility, the ease of testing, and the knowledge that the infection could easily be treated with antibiotics. However, women stressed that it was important to receive adequate information in order to make an informed choice about whether or not to accept the test. CONCLUSIONS: The complexity of messages to be conveyed when offering a Chlamydia screening test, for instance regarding the symptomless nature of the infection and the implications of a positive result, mean that the time taken to communicate this adequately should not be underestimated.