More appointments for a GP led local Menstrual Dysfunction Clinic are being added to fit local demand. The clinic, which has been running monthly since March 2010, may have to run twice monthly.
The clinic at Greystone House Surgery in Redhill is run by Dr Heidi Fahy, along with an experienced practice nurse and a sonographer. One hour appointments are given to each patient, which aims for a ‘one-stop-shop’ service which includes an ultrasound pelvis scan.
Women over forty with dysfunctional uterine bleeding are the target group. The clinic is for certain groups of women only and must meet the following criteria: Any woman on HRT who has irregular or unexpected bleeding OR any women over 40 with intermenstrual bleeding or menorrhagia with no identified co-existent pathology and no desire for surgical intervention.
In those women who have a normal scan and do not wish any surgical intervention, the only investigation required is an endometrial or pipelle biopsy, which takes a small sample of the lining of the womb, and does not require any sedation or anaesthetic. These pipelle samples are taken in the clinic and the results forwarded to the patient and their GP. During the clinic women with heavy bleeding and normal scans are also offered the opportunity to have a Mirena coil fitted. Swabs and smears will also be taken where appropriate. Therefore it is possible in one local visit for a patient to be reassured that the bleeding is not of a sinister cause and have a treatment which is effective in the majority of cases.
Patients with abnormal scans, abnormal histology or difficulties obtaining a pipelle sample, are referred on to the hospital Gynaecology Clinic. Often in the case of abnormal scan, the secondary care appointment is arranged before they leave the clinic. This primary care clinic does however avoid the need for a secondary care referral in the majority of cases.
The Menstrual Dysfunction clinic has had a good number of referrals since the clinic started in March 2010, seeing 5-10 patients per clinic. However, most referrals are coming from a small number of practices and it is hoped that other practices in the ESyDoc LLP will soon take up this opportunity for their female patients with dysfunctional uterine bleeding.
