Heavy menstrual bleeding: An update on management

Davies, J.; Kadir, Rezan A.

doi:10.1016/s0049-3848(17)30072-5

Cited by 69 publications

(56 citation statements)

References 65 publications

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“…A recent prevalence of menorrhagia among women from different parts of the world has shown that worldwide, 36%–38% of women are affected by menorrhagia (Brink et al, ; Bruinvels, Burden, Brown, Richards, & Pedlar, ; Harlow & Campbell, ; Marsh et al, ). Being diagnosed with menorrhagia negatively influences a woman's physical (Napolitano et al, ; Santer, Wyke, & Warner, ; Weisberg, McGeehan, & Fraser, ), emotional (Santer et al, ; Weisberg et al, ) and social statuses (Davies & Kadir, ). Iron‐deficiency anaemia is an associated complication (Napolitano et al, ) that may cause such women to experience fatigue and lethargy (Andrews, ).…”

Section: Introductionmentioning

confidence: 99%

“…Being diagnosed with menorrhagia negatively influences a woman's physical (Napolitano et al, 2014;Santer, Wyke, & Warner, 2007;Weisberg, McGeehan, & Fraser, 2016), emotional (Santer et al, 2007;Weisberg et al, 2016) and social statuses (Davies & Kadir, 2017). Iron-deficiency anaemia is an associated complication (Napolitano et al, 2014) that may cause such women to experience fatigue and lethargy (Andrews, 2009).…”

Section: Introductionmentioning

confidence: 99%

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Perspectives of women experiencing Menorrhagia: A descriptive qualitative study

Kamaludin

Zhang

Shorey

2019

Journal of Clinical Nursing

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Objective To describe the perspectives and support needs of women experiencing menorrhagia in Singapore. Background Women with menorrhagia lack awareness regarding the severity of menorrhagia. There is a dearth of literature understanding the support needs of women with menorrhagia. Design A descriptive qualitative study design was adopted. The Consolidated crieteria for Reportig Qualitative Research (COREQ) was used to report the findings of this study. Methods The study was conducted at a tertiary public hospital in Singapore from July 2017–October 2017. Semi‐structured interviews were used to collect data from 16 women who were diagnosed with menorrhagia. The total number of interviews was concluded based on data saturation. The interviews were transcribed verbatim, and thematic analysis was used to analyse the interview transcripts. The COREQ was used to report the findings of this study. Results Participants reported that they were unaware about menorrhagia and its severity. Various internal and external factors influenced the participants’ awareness and understanding of menorrhagia. Although the participants received support to cope with menorrhagia, the support was deemed insufficient. The women shared that menorrhagia had affected their lives physically, emotionally, socially and financially. They used both external and internal coping mechanisms to cope with their conditions and looked for information through close contacts and the Internet. They longed to learn more about their conditions. Conclusion Multiethnic Singaporean women with menorrhagia lacked awareness about their conditions and the severity, which affected their lives negatively. There should be greater efforts to raise the public's awareness of menorrhagia so that women can seek medical help early and minimise its negative influence on their lives. Relevance to clinical practice Healthcare providers need to pay greater attention to menorrhagia in order to provide more holistic care and support for those experiencing this condition. Healthcare professionals should understand their patients’ experiences with menorrhagia and evaluate their current support resources in order to create a strong support system.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Perspectives of women experiencing Menorrhagia: A descriptive qualitative study

Kamaludin

Zhang

Shorey

2019

Journal of Clinical Nursing

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“…The levonorgestrel intrauterine system (LNG‐IUS) has been shown to be effective and well accepted by these women . LNG‐IUS is the most effective medical treatment for HMB . It also provides effective contraception for 5 years with very low failure rates of <0.1%.…”

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confidence: 99%

Heavy menstrual bleeding in women with inherited bleeding disorders

et al. 2020

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Advances in clinical care and research in the field of inherited bleeding disorders (IBD) have focused mainly on male patients with haemophilia. This has overshadowed other bleeding disorders, and the recognition that women are also affected by bleeding disorders such as von Willebrand disease or other rare bleeding disorders and the impact of the disease on their daily life. 1 Similarly, bleeding risks in carriers of haemophilia are often overlooked.Management of a bleed in women with IBD is not different from men when it comes to surgery, epistaxis, muscle and joint bleed but menstruation, pregnancy and childbirth are unique haemostatic challenges.Up to 90% of women with IBD have heavy menstrual bleeding (HMB). 1 HMB may be the only bleeding symptom in up to 20% of adolescents. 2 More than 70% of women with VWD suffer from HMB, and half of them suffer from dysmenorrhoea. 3 The duration of menstruation is reported to be significantly longer and episodes of flooding significantly more common in patients with IBD compared to the general population. 4 Menstrual blood loss is reported to be heavy throughout menstruation in women with IBD women whereas women without IBD tend to have the heaviest bleeding in the first 3 days 4 There is also a risk of bleeding with ovulation leading to recurrent mid-cycle pain or more serious complications such as large AbstractHeavy menstrual bleeding (HMB) is the commonest bleeding symptom among women with inherited bleeding disorders (IBD). Since HMB starts at the very onset of menarche and continues throughout the reproductive life, the health related quality of life of these women is affected and they are at an increased risk of developing iron-deficiency anemia. Because of the entrenched stigma and taboos, women and girls are often reluctant to discuss the problem of HMB within their families and do not seek medical advice. Increased awareness and multidisciplinary management approach for the management of these women are essential in ensuring an optimal outcome. It is important to take a careful history and undertake a thorough gynecological assessment to exclude other underlying/concomitant causes of HMB.Iron supplementation is essential. Strategies for decreasing menstrual blood flow are similar to those used for HMB in general with the addition of desmopressin and replacement therapy and the exclusion of non-steroidal anti-inflammatory drugs.Tranexamic acid and/or hormonal intervention are usually recommended as first-line therapy. Treatment choice should be individualized taking into account whether the woman wishes to preserve her fertility, if she requires contraception, the type of IBD, the severity of bleeding, and her social and religious background as well as acceptability and availability of the treatment options. K E Y W O R D Sbleeding disorders, hormonal therapy, heavy menstrual bleeding, psychosocial, women | 17 DJAMBAS KHAYAT eT Al.

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“…Heavy menstrual bleeding may lead to iron deficiency and anemia. Additionally, heavy menstrual bleeding increases the use in health care services, along with higher surgical interventions rates 52,53 . Previous studies have found an association between 2D:4D and menstrual characteristics.…”

Section: Discussionmentioning

confidence: 99%

The association between second to fourth digit ratio, reproductive and general health among women: findings from an Israeli pregnancy cohort

Tabachnik

Wainstock

2020

Sci Rep

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The ratio between the length of second and fourth digits (2D:4D) is a putative biomarker for prenatal testosterone and estrogen exposure. The aim of the study was to examine the association between 2D:4D and women's general and reproductive health. This analysis was conducted within a prospective pregnancy cohort study. The study population included 187 women. 2D:4D was measured directly in both hands using a digital caliper. Multivariable linear and logistic models were used to study the associations between digit ratio and the studied health characteristics. Mean age of the participants was 30.7 ± 4.9 years. The mean age at menarche was 12.9 ± 1.4 years. Right hand 2D:4D mean ± SD was 0.965 ± 0.03. Left hand 2D:4D mean ± SD was 0.956 ± 0.03. An association was found between right 2D:4D and age at menarche, with older age in women with 2D:4D ≥ mean versus 2D:4D < mean (13.2 ± 1.5 and 12.8 ± 1.3 respectively, b = 0.48, 95%CI:0.06-0.91) while controlling for ethnicity. Higher 2D:4D was also associated with heavier menses bleeding and dysmenorrhea. There is an association between 2D:4D and sub optimal reproductive characteristics, including later age at menarche, heavier menses bleeding and dysmenorrhea. These findings support the association between the intrauterine period and reproductive characteristics. further studies are required to support our findings. The ratio between lengths of the second and the fourth digits (index and ring fingers) (2D:4D) is a putative biomarker of prenatal testosterone and estrogen exposure 1. 2D:4D is sexually dimorphic, and males' 2D:4D is relatively shorter than females' 2,3. 2D:4D is observed at as early as the end of the first trimester 4,5. Relative digit length is considered steady at ages 2 to 25 6 , although other studies suggest that 2D:4D does mildly increase during childhood but remains steady during puberty 7,8. 2D:4D was suggested to be associated with Hox gene family 2,3. Homeobox genes Hox a and Hox d may indirectly influence the prenatal production of androgen by controlling the differentiation of the urogenital system as well as digit development. Considering this, it was suggested that there may be an association between prenatal hormonal function and digit formation, and 2D:4D was proposed as an indicator of first trimester testosterone and estrogen levels, reflecting the Hox genes' action on differentiation 9,10. Environmental exposure to toxicants is critical during early development stages, such as the perinatal period, in which there is a heightened vulnerability to exposures due to potential permanent effect on health and development 11. Previous research showed association between prenatal hormonal environment and exposure to endocrine disrupting chemicals and 2D:4D in animals 12,13 and humans 2,10,14-16. Conversely, some studies found no support for such association 17-19. Assessing the prenatal hormonal environment directly from the fetus in utero is challenging because of the risk for the fetus. Therefor other methods have been used to evaluate prenatal ...

show abstract

Heavy menstrual bleeding: An update on management

Cited by 69 publications

References 65 publications

Perspectives of women experiencing Menorrhagia: A descriptive qualitative study

Perspectives of women experiencing Menorrhagia: A descriptive qualitative study

Heavy menstrual bleeding in women with inherited bleeding disorders

The association between second to fourth digit ratio, reproductive and general health among women: findings from an Israeli pregnancy cohort

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