Hayley Harrison’s periods started as they continued — with a flood of blood.
Her first one at age 14 happened in the middle of a school day. She bolted from her classroom, relying on her dark pants to disguise what was happening.
“By the time I got to the front office, I had actually flooded through, and it looked like I’d wet myself, so it was quite a shocking start to my menstrual cycle,” she said.
It was 18 years before a doctor told Hayley that it wasn’t normal and 26 before she received treatment that offered relief.
Her periods were so heavy she would bleed through pads and tampons every hour, even during the night.
Her periods caused her anxiety in public, severe pain and fatigue from low iron levels.
Lasting for eight to 10 days, her menstrual bleeding meant she had to carry a huge bag of supplies and extra clothes, and often missed out on things she loved, like travel and swimming.
“It has impacted on so much of my life … it just drains everything from you,” she said.
Concerns some women aren’t seeking help
It wasn’t until she was 40 that she had treatment to bring an end to her torment.
Endometrial ablation is a procedure that reduces or stops menstrual bleeding by removing the lining of the uterus.
“That was possibly the most amazing procedure I’ve had in my life,” Hayley said.
But there are concerns not enough women with heavy periods get the kind of treatment Hayley had — or any treatment at all.
One in four women and people who have periods experience heavy menstrual bleeding and only half of them seek medical help, according to a new report from the Australian Commission on Safety and Quality in Health Care.
Heavy menstrual bleeding can be defined as needing to change tampons or pads every one to two hours, or losing more than 80mls each cycle. Ultimately though, experts say if your periods are so heavy they interfere with your life, it’s worth seeking treatment.
Of those that do get treatment, an unusually high number of them will have a hysterectomy — surgery to remove the uterus.
The commission’s clinical director, Liz Marles, says while hysterectomy is an option that can provide much-needed relief, it’s not something to be taken lightly.
“It is a major operation, it requires a general anaesthetic, hospitalisation, often for a couple of days, it’s got more risk of complications around things like infection and bleeding,” she said
“We don’t want to do a really invasive procedure where there is something less invasive, that will give you better outcomes or equivalent outcomes without the risk.”
Australia’s high hysterectomy rates
New data from the commission shows Australia’s overall hysterectomy rate for non-cancerous reasons has fallen by 20 per cent in the last eight years but remains significantly higher than comparable countries like the UK and New Zealand.
OECD data from 2019 shows there were 215 hysterectomies performed in Australia per 100,000 women, while in New Zealand the rate was 126 procedures and in the UK 132.
In Australia, the rate of hysterectomy is particularly high in regional and remote areas, the commission said.
There is also a 9 per cent higher rate of hysterectomy among First Nations women.
Dr Marles says it’s not good enough that Australian women do not have equal access to all treatment options.
“We want every woman, no matter where they live in Australia, to be able to access the full range of treatments,” she says.
Changes to improve care
The commission has today updated its Heavy Menstrual Bleeding Clinical Care Standard to improve treatment options for all women by explaining the care they should be offered.
The changes include adding to the recommended treatment options and offering guidance on the timing of some investigations.
The standard recommends doctors give all women living with heavy menstrual bleeding a thorough assessment and support them to make an informed choice about treatment.
One of their recommendations is that doctors help patients feel comfortable talking about their periods because it can be a sensitive topic for some women.
For the first time, the clinical standard now includes a recommendation to provide all women with cultural safety.
Tracey Brand, chief executive officer of the Derbal Yerrigan Health Service and proud Eastern Arrernte woman, says cultural safety for Indigenous women includes having access to Indigenous staff and nurses at the healthcare service, and having their choices about treatment and cultural beliefs respected.
Ms Brand says it’s important for more healthcare services and hospitals to embed cultural safety practices so that Indigenous women can access all available treatments, including having hormonal IUDs inserted, or endometrial ablation.
That also means making female clinicians available.
“If it is an Aboriginal woman that’s presenting for a women’s health concern, we don’t get them to see a male clinician,” she says.
Gynaecologist and obstetrician, Nisha Khot, is on the board of the Multicultural Women’s Health Association and says cultural safety is a critical aspect of the guidelines and it will benefit women from all walks of life.
“Women who come from culturally and linguistically diverse backgrounds are less likely to seek healthcare in general, but specifically less likely to seek health care related to periods”.
She says doctors should be aware some women may not be comfortable talking about menstruation with a male doctor, or with a male translator in the room.
She notes this is not something women should have to ask for.
“We as healthcare providers should be asking what their preference is,” she says.
As Dr Khot sees it, many women feel they are not heard when they talk to healthcare professionals about conditions such as heavy periods.
She wants doctors to hear what women are saying, validate their symptoms and suffering, then follow up with treatment options.
Heading in the right direction
Even though the hysterectomy rate in Australia is higher than elsewhere, the commission says it’s encouraging that more women appear to be choosing less invasive procedures.
Their data shows there’s been a 10 per cent increase in endometrial ablations.
Since having that treatment, Hayley Harrison no longer worries when her period will start, where the bathrooms are or when she can leave an event to change a pad.
She can wear white, go running and plan camping trips.
And she’s taken up volunteer roles because she no longer lives with the tiredness that comes with having low iron levels.
“It’s been a complete game changer,” she says.
Dr Marles says women should not have to modify their activities, miss work, and experience fatigue, because they’ve got their period.
“We don’t think in this day and age that you should have to put up with this,” she says.
Loading…
Posted , updated