Identification and evaluation of barriers and facilitators to formal help-seeking for premenstrual symptoms in the UK: a mixed methods approach

Introduction: Premenstrual symptoms are common physical, psychological, and behavioural symptoms that occur before the onset of menstruation. Despite their cyclical nature, these symptoms can be severe and burdensome, potentially interfering with daily life. Although interventions are available, help-seeking remains infrequent, raising questions about the barriers to engaging in formal care. This study employed a mixed-methods approach to examine both barriers and facilitators to help-seeking and assess their relative impact. Methods: An online survey was developed, incorporating questions about premenstrual symptoms and quantitative and qualitative questions on barriers and facilitators to formal help-seeking. Participants included both previous help-seekers and non-help-seekers to allow for group comparisons. Data were collected from 592 UK-based participants. Quantitative data were analysed descriptively, with group differences assessed using Mann-Whitney U and Chi-square tests, as appropriate. Qualitative responses were analysed using thematic analysis. Results: = 339) had. Overall, the most common and strongest barrier to help-seeking regarded concerns that healthcare professionals (HCPs) would not take symptoms seriously or would act dismissively. Significant group differences were observed in the barriers endorsed, with non-help-seekers being more likely to think professional care would be ineffective and wanting to solve problems on their own. Previous help-seekers were more likely to endorse previous poor care experiences as a barrier. Qualitative analysis revealed that anticipated HCP knowledge and attitudes, along with lack of awareness and education, were the most frequently reported barriers. Among non-help-seekers, improving education and awareness was commonly cited as a potential facilitator of formal help-seeking. Discussion: Concerns of being dismissed or not taken seriously by HCPs was the most influential factor in deciding whether to seek help or not. Additionally, lack of awareness and education was identified as a key barrier, including uncertainty about whether symptoms were "severe" enough to justify seeking formal care and doubt regarding the range and efficacy of treatment options. To facilitate help-seeking, efforts should focus on improving education for individuals experiencing premenstrual symptoms and enhancing the quality of care interactions to address concerns about poor care experiences.