Significant social class gradient in menstrual disorders.

EDITOR,-Diana Kuh and Susan Stirling report significant educational gradients for risk of admission for diseases of the female genital system and breast, and in particular for menstrual disorders: 1% of highly educated women were admitted to hospital for menstrual problems compared with 19% of those with minimal qualifications. 1 Social gradients were also observed for hysterectomies and dilatation and curettage: 37% and 44% of these procedures, respectively, were related to menstrual problems. The authors refer to a slight increase in rates of hysterectomy since the 1970s. They were unable, however, to establish whether increased risks of admission and surgery among less educated women and women of lower social class reflected the prevalence of disease or a different pattern of primary and secondary care.