In comparison to other OECD nations, Australia still has high hysterectomy rates, even though women are increasingly opting for less surgical methods to address heavy monthly flow.
The Women’s Health Hub, which was released this week by the Australian Commission on Safety and Quality in Health Care (ACSQHC), contains national data showing a 10% increase in the rates of endometrial ablation, a less invasive treatment option for heavy menstrual bleeding, and a 20% decline in the rates of hysterectomy over an eight-year period.
The Heavy Menstrual Bleeding Clinical Care Standard has been updated by the ACSQHC with the goal of giving women more access to treatment alternatives and empowering them to make educated healthcare decisions. The 2024 edition expands upon the 2017 version, which was created in response to an unexplained difference in hysterectomy rates around Australia.
While these results are encouraging, Australia still has a ways to go before ensuring that women with excessive monthly bleeding have access to the full spectrum of treatment choices, according to Associate Professor Liz Marles, GP and Clinical Director of the ACSQHC.
“Many women live with heavy periods, which is a hidden problem,” the speaker stated.
Some women may find it uncomfortable to discuss such a delicate subject with their doctor. Through its efforts, the Commission speaks up for these women, many of whom have experienced significant life changes.
“We want women to feel comfortable discussing their periods, to know they don’t have to put up with symptoms, and to know that there are a variety of treatments available that don’t always require a major operation.”
The updated clinical care standard and additional data are intended to enhance knowledge of the advantages and disadvantages of therapies for excessive menstrual bleeding. Oral medications, hormonal IUDs, and treatments like endometrial ablation—which involves heating the lining of the uterus—are among the options for controlling heavy periods. The major surgery of a hysterectomy is the most intrusive form of treatment.
The new Women’s Health Focus Report from the ACSQHC looks at the two procedures as part of the launch.
Although the number of invasive surgeries to treat heavy periods has decreased, Australia still has a much greater rate of hysterectomy than other comparable OECD nations, like the UK and New Zealand.
An estimated 24,030 Australian women over the age of 15 who were diagnosed with conditions other than cancer underwent hysterectomy in 2021–2022. 2019 saw 215 hysterectomy cases per 100,000 women, compared to 132 cases in the UK and 126 cases in New Zealand.
Geographical regions with the highest and lowest rates of both treatments are listed in the report, highlighting differences in population density.
Regional locations exhibit greater rates of hysterectomy and endometrial ablation compared to big cities and remote areas. Notably, hysterectomy rates are 9% higher among Aboriginal and Torres Strait Islander women.
These results, according to Associate Professor Marles, show that availability to therapies for excessive menstrual bleeding varies across the country and emphasize the need for care that is culturally competent.
“Care that is individualized for each woman should be available,” she declared.
However, we are aware that women’s worries about excessive monthly bleeding are sometimes disregarded and that getting the right care can be challenging.
“There may be more work to be done given that treatment varies depending on a person’s place of residence.”
According to the Women’s Health Focus Report, one in four women who are of reproductive age experience significant menstrual bleeding, yet less than one in two of them seek medical attention. The factors influencing treatment decisions included the reason for the bleeding, the desire for future conception, the requirement for contraception, and co-existing conditions.
According to Associate Professor Marles, the ACSQHC is collaborating with Australia’s healthcare system to enhance care for women experiencing excessive menstrual bleeding, and the updated clinical care standard offers recommendations for more equal access.
“Let’s upskill the healthcare workforce so practitioners can administer minimally invasive treatments, like the hormonal IUD, if appropriate and women are offered the full suite of treatment options,” the speaker stated.
In order to ensure that women receive the best therapy possible—which varies depending on their unique needs—health professionals should inquire about the menstrual health of their patients.
While some women may decide to have a hysterectomy, we wish to prevent them from undergoing the most intrusive treatment without first providing them with information on the risks and advantages and a less invasive and effective alternative.
