PB1387 - Heavy menstrual bleeding from anticoagulation therapy significantly impacts on women’s quality of life – findings from the PERIOD programme of work

Background: There is increasingly recognition that women prescribed anticoagulant therapy experience heavier bleeding during their menstrual cycles, potentially impacting on their quality of life (QoL). Little research exists which reports this, from the women’s perspective.

Aims: To quantify menstrual blood loss and quality of life in women newly prescribed anticoagulant therapy following initiation of anticoagulation therapy, compared to a control group.

Methods: Women between the ages of 18-50, newly commenced on anticoagulation therapy were recruited from the anticoagulation clinics at King’s College Hospital, UK. Subjects were asked to complete two online validated instruments: the menstrual bleeding questionnaire and a menstrual pictogram, during two consecutive menstrual cycles. In parallel, a control group was recruited. Descriptive statistics was used to analyse the data, with non-parametric tests applied to compare differences between groups. Ethical approval for the study has been granted (REC reference: 19/SW/0211).

Results: 102 women returned completed questionnaires; 38 in the anticoagulated group and 64 in the control group. Table 1 outlines the demographic information. Table 2 compares the menstrual pictogram blood loss and menstrual questionnaire quality of life scores during cycle 1 and cycle 2 for both groups. Menstrual pictogram blood loss significantly correlated with menstrual QoL scores, Spearman’s rho 0.673 (cycle 1) and 0.693 (cycle 2), p< 0.001. Women in the anticoagulated group were more likely to miss days off work, avoid social activities, experience episodes of bleeding that soaked through to outer clothing and report the end date of their cycle being unpredictable, compared to the control group.

Conclusion(s): Our findings confirm that women newly commencing oral anticoagulation suffer with heavy menstrual bleeding (HMB) which significantly impacts on their quality of life. Further research which helps to identify those women more likely to suffer with HMB and circumventing this, along with determining the optimal anticoagulant treatment strategy is required.