scholarly journals Pictorial Blood Loss Assessment Chart for evaluating heavy menstrual bleeding in Asian women

2021 ◽  
Vol 27 (6) ◽  
pp. 399-404
Author(s):  
Jennifer KY Ko ◽  
Terence T Lao ◽  
Vincent YT Cheung
Keyword(s):  
Blood Loss ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Asian Women ◽  
Loss Assessment

scholarly journals Role of LNG-IUS in adenomyosis in reproductive age group women: a prospective interventional study

2019 ◽  
Vol 8 (4) ◽  
pp. 1254
Author(s):  
Eshna Gupta ◽  
Shashi Prateek ◽  
Poonam Mani ◽  
Lalita Yadav ◽  
Mamta Tyagi ◽  
...  
Keyword(s):  
Blood Loss ◽  
Assessment Tool ◽  
Subjective Assessment ◽  
Reproductive Age ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Common Side Effect ◽  
Loss Assessment

Background: The objective of the present study was to observe the efficacy of LNG-IUS in the treatment of heavy menstrual bleeding and dysmenorrhoea associated with adenomyosis.Methods: LNG-IUS was inserted in forty women between 20-50 years of age presenting with heavy menstrual bleeding and dysmenorrhoea associated with adenomyosis diagnosed on transvaginal ultrasonography and followed up after 1 month, 3 months and 6 months of insertion. Subjective assessment of menstrual blood loss was done by pictorial blood loss assessment chart and dysmenorrhoea was assessed on the basis of universal pain assessment tool and side effects were noted at each visit.Results: Mean patients’ age was between 31-40 years (72.5%) and the follow up duration was 6 months. Significant improvements in dysmenorrhea, HMB and haemoglobin levels were observed. There was no significant change in the uterine volume. The most common side effect was prolonged vaginal spotting (n=26, 65%) and pain abdomen (n=13, 32.5%). LNG-IUS expulsion was observed in 1 patient (n=1, 2.5%). 3 patients underwent hysterectomy (n=3, 7.5%). The overall success rate of LNG-IUS was 82.5%.Conclusions: The LNG-IUS appears to be an effective method in alleviating dysmenorrhoea and heavy menstrual bleeding associated with adenomyosis during 6 months of study. It may be a valuable long-term alternative for the treatment of adenomyosis in young and perimenopausal women and it is a good strategy to reduce the number of hysterectomies in women with adenomyosis.

scholarly journals Management of heavy menstrual bleeding on anticoagulation

Hematology ◽  
2020 ◽  
Vol 2020 (1) ◽  
pp. 533-537
Author(s):  
Bethany Samuelson Bannow
Keyword(s):  
Iron Deficiency ◽  
Blood Loss ◽  
Oral Anticoagulants ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
School Work ◽  
Medical Interventions ◽  
Recurrent Venous Thromboembolism ◽  
Menstruating Women ◽  
Hormone Therapies

Abstract Heavy menstrual bleeding (HMB) is a common complication of anticoagulation, affecting ∼70% of menstruating women receiving oral anticoagulants. The risk of HMB is lower with apixaban and/or dabigatran than with rivaroxaban. HMB can result in iron deficiency with or without anemia, increased need for medical interventions, decreased quality of life, and missed school/work. Mainstays of treatment include hormone therapies such as the levonorgestrel intrauterine system, subdermal implant, and other progesterone-based therapies, which can result in decreased blood loss and, in some cases, amenorrhea. Combined hormone therapies can be used while patients continue receiving anticoagulation and are also highly effective for decreasing menstrual blood loss. Rarely, procedure-based interventions such as endometrial ablation may be required. Patients should be evaluated for iron deficiency and anemia and offered supportive therapies as needed. Abbreviating the course of anticoagulation or skipping doses can increase the risk of recurrent venous thromboembolism by as much as fivefold, but switching oral anticoagulants may be considered. Awareness of HMB and careful history taking at each visit are crucial to avoid a missed diagnosis.

scholarly journals Relugolix for oral treatment of uterine leiomyomas: a dose-finding, randomized, controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hiroshi Hoshiai ◽  
Yoshifumi Seki ◽  
Takeru Kusumoto ◽  
Kentarou Kudou ◽  
Masataka Tanimoto
Keyword(s):  
Clinical Trial ◽  
Blood Loss ◽  
Adverse Events ◽  
Primary Endpoint ◽  
Symptom Relief ◽  
Gnrh Receptor ◽  
Uterine Leiomyomas ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Link Type

Abstract Background Uterine leiomyomas are the most common neoplasm affecting women and frequently cause heavy menstrual bleeding and pain. Gonadotropin-releasing hormone (GnRH) receptor antagonists provide fast symptom relief and show promise as a medical (non-surgical) treatment option and as a presurgical treatment to reduce leiomyoma size. The aim of this study was to evaluate the efficacy and safety of three dose levels of oral relugolix, a small molecule GnRH receptor antagonist, in Japanese women with uterine leiomyomas and heavy menstrual bleeding. Methods This phase 2, multicenter, double-blind, parallel-group study was conducted at 36 sites in Japan in women with uterine leiomyomas and heavy menstrual bleeding, defined as a pictorial blood loss assessment chart (PBAC) score of ≥ 120 in one menstrual cycle. Patients were randomized 1:1:1:1 to relugolix 10, 20, or 40 mg, or placebo, orally once daily for 12 weeks. The primary endpoint was the proportion of patients with a total PBAC score of < 10 from week 6 to 12. A sample size of 50 patients per group was estimated to provide ≥ 95% power, based on the comparison of relugolix 40 mg with placebo using a chi-square test with a significance level of 5% (two-sided). Results From November 2011 to September 2012, 216 patients were randomized and 214 patients (99.1%) were analyzed. The proportion (difference vs. placebo) of patients that achieved the primary endpoint in the placebo and 10-, 20-, and 40-mg relugolix groups were 0%, 20.8% (95% confidence interval [CI]: 9.3–32.3, P < .001), 42.6% (95% CI: 29.4–55.8, P < .001), and 83.3% (95% CI: 73.4–93.3, P < .001), respectively. Though treatment-emergent adverse events were similar between the 20- and 40-mg groups, the incidence rates were more frequent compared with the placebo group. Most of these adverse events were mild or moderate in intensity. Conclusions Relugolix decreased menstrual blood loss in women with uterine leiomyomas in a dose–response manner, and was generally well tolerated. Clinical trial registration: ClinicalTrials.gov, https://clinicaltrials.gov/ct2/show/NCT01452659, NCT01452659 (registered 17/10/2011); JAPIC Clinical Trial Information, https://www.clinicaltrials.jp, JapicCTI-111590 (registered 31/08/2011).

Normalization of blood loss in women with heavy menstrual bleeding treated with an oral contraceptive containing estradiol valerate/dienogest

Contraception ◽  
2012 ◽  
Vol 86 (2) ◽  
pp. 96-101 ◽  
Author(s):  
Ian S. Fraser ◽  
Jeffrey Jensen ◽  
Matthias Schaefers ◽  
Uwe Mellinger ◽  
Susanne Parke ◽  
...  
Keyword(s):  
Oral Contraceptive ◽  
Blood Loss ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Estradiol Valerate

Estimating a meaningful reduction in menstrual blood loss for women with heavy menstrual bleeding

2010 ◽  
Vol 26 (11) ◽  
pp. 2673-2678 ◽  
Author(s):  
Andrea S. Lukes ◽  
Ken Muse ◽  
Holly E. Richter ◽  
Keith A. Moore ◽  
Donald L. Patrick
Keyword(s):  
Blood Loss ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Menstrual Blood ◽  
Menstrual Blood Loss

scholarly journals The Association between Heavy Menstrual Bleeding and Depressive Symptoms in Adolescents

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4230-4230
Author(s):  
Sanila Sarkar ◽  
Laura Benjamins ◽  
Sudad Kazzaz ◽  
Neethu M Menon
Keyword(s):  
Depressive Symptoms ◽  
Blood Loss ◽  
Young Women ◽  
Adolescent Females ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Chi Square ◽  
Test Of Independence ◽  
Adolescent Population ◽  
Chi Square Test

Abstract Introduction: Heavy menstrual bleeding (HMB) is a type of abnormal uterine bleeding (AUB) that affects 30% of women of reproductive age and up to 40% of adolescents. Furthermore, 10-40% of adolescents with HMB have an underlying inherited bleeding disorder like von Willebrand disease or platelet dysfunction, requiring management by pediatric hematologists. HMB has been described as more than 80 ml of blood loss during one cycle and clinically, it is defined by several parameters such as the length of each cycle, severity of soaking through pads or tampons, size of clots passed and pictorial blood loss assessment chart (PBAC) score. Studies in adult women show a significant impact of HMB on their psychosocial and financial health. However, little is known about the psychological effects of HMB in adolescent females. In the adolescent population, depression is twice as common in females as it is in males, likely due to a combination of biological and social differences. In this study, we examine the association between heavy menstrual bleeding and depressive symptoms in adolescent girls. Methods: We conducted a retrospective records review of adolescent females aged 10-21 years that were seen as new patients at the Adolescent Medicine and Young Women's Bleeding Disorders clinics at our institution between January 1, 2018 and March 31, 2020. Patients were included in the study if they had started menses, and had a doumented menstrual history as well as a completed Patient Health Questionnaire (PHQ-9), a validated screening tool for depression.Patients with a severe underlying chronic medical disorder (Including but not limited to end stage renal disease, Juvenile Rheumatoid Arthritis, Systemic Lupus Erythematosis, severe eating disorder, previously diagnosed bipolar disorder or psychotic disorders) were excluded. HMB was determined by either a PBAC score of &gt;100 or the presence of two or more of the following criteria: Menses lasting &gt;7days Soaking through pad or tampon &lt;1hr Soaking through bed clothes or changing pads at night Passing large clots Low ferritin &lt; 15ng/ml (indicative of low iron stores) Anemia with Hemoglobin &lt; 12g/dl not due to any other cause (e.g. dietary, immunosuppression, medication induced) Depression was determined by a PHQ-9 score of 9 or greater. The two variables were dichotomized, and a chi-square test of independence was performed to test the association with a significance level of p &lt; 0.05. Results: A total of 203 records were reviewed after meeting inclusion and exclusion criteria. The mean age was 15.94 years (median 16, mode 16) with a range of 12-20years. 42 girls (20.7%) had a PHQ-9 score of &gt;9 and 52 (25.6%) had HMB. Eighteen of the 42 patients (42.8%) with elevated PHQ-9 score had HMB and 34/52 patients (65.3%) with HMB had an elevated PHQ-9 score. Pearson's chi-square test of independence showed a significant relation between HMB and PHQ-9 score of 9 or more with χ 2 (1, n=203) = 8.2618, p = 0.004. After the application of Yates correction, the result was still significant with χ 2 = 7.1603 and p = 0.007. Discussion and Conclusions: This study shows a significant association in the adolescent population between heavy menstrual bleeding and moderate or severe depression as defined by the presence of a PHQ-9 score of 9 or more. This retrospective analysis does not establish causation, but demonstrates a clinically noteworthy finding that has not been described before. The PHQ-9 is used widely across this population to screen for depression, but it is also important to screen young women aged 10-21years for HMB as a contributing factor to depression followed by timely and appropriate management of both problems. Additionally, it may be worthwhile to evaluate all young women with HMB through additional methods to diagnose depression as this patient population appears to be at higher risk. Future prospective studies are needed to better characterize this association. Disclosures No relevant conflicts of interest to declare.

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