Menstrual bleeding patterns in pre‐ and perimenopausal women: a population‐based prospective diary study

Astrup, Karen; Olivarius, Niels de Fine; Møller, Susanne; Gottschau, Adam; Karlslund, Willy

doi:10.1111/j.0001-6349.2004.00401.x

Cited by 17 publications

(8 citation statements)

References 11 publications

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“…A similar result was seen in a Danish study which observed obese women were more likely to report menstrual flooding but not prolonged menstrual bleeding 18 . In the SWAN Daily Hormone Study, obesity was also associated with 3 or more days of heavy bleeding 31 .…”

Section: Discussionsupporting

confidence: 84%

“…A similar result was seen in a Danish study, which observed that obese women were more likely to report menstrual flooding but not prolonged menstrual bleeding. 18 In the SWAN Daily Hormone Study, obesity was also associated with three or more days of heavy bleeding. 31 The Michigan Bone Health and Metabolism Study did not find an association between menses duration and BMI in women aged 25-50 years.…”

Section: Discussionmentioning

confidence: 99%

“…[13][14][15] The classic study by Hallberg et al of menses volume demonstrated that 50-year-old women have a higher median menstrual blood flow than younger women. 16 Two European studies, of 1-year duration, have reported the cumulative incidence of 10+ days of bleeding to be 14.7% 17 and the period prevalence to be 36-49%, 18 while the cumulative incidence of heavy periods was 53%. 18 Previous perimenopausal studies of menses, [17][18][19][20] which included mostly white participants, were short in duration and unable to characterise bleeding during the whole MT.…”

Section: Introductionmentioning

confidence: 99%

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Bleeding patterns during the menopausal transition in the multi‐ethnic Study of Women's Health Across the Nation (SWAN): a prospective cohort study

Paramsothy

Harlow

Greendale

et al. 2014

BJOG

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Objective Prior studies describing menses duration and heaviness of flow during the menopausal transition (MT) have been short in duration and limited to white women. We estimated the frequency of and risk factors for prolonged bleeding, spotting, and heavy bleeding during the MT in an ethnically diverse population. Design Prospective community–based cohort study. Setting United States: Southeastern Michigan, Northern California, and Los Angeles, California. Population 1320 midlife women who participated in the Study of Women’s Health Across the Nation (SWAN) Menstrual Calendar Substudy. Participants included African-American, white, Chinese, and Japanese women. Methods Women completed daily menstrual calendars from 1996–2006, and provided information on hormone therapy, smoking and physical activity. Annual measures included height and weight. Kaplan-Meier survival analysis and multivariable regression were used to analyze the data. Main Outcome Measures Menses of 10+ days, spotting of 6+ days, heavy bleeding of 3+ days. Results At least three occurrences of menses 10+ days was reported by 77.7% (95%CI: 56.7, 93.2), of 6+ days of spotting by 66.8% (95%CI: 55.2, 78.0) and of 3+ days of heavy bleeding by 34.5% (95%CI: 30.2, 39.2) of women. Menses of 10+ days, 6+ days of spotting, and 3+ days of heavy bleeding were associated with MT stage, uterine fibroids, hormone use, and ethnicity. BMI was associated with 3+ days of heavy bleeding. Conclusions These data provide clinicians and women with important information about the expected frequency of prolonged and heavy bleeding and spotting during the menopausal transition that may facilitate clinical decision making.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Bleeding patterns during the menopausal transition in the multi‐ethnic Study of Women's Health Across the Nation (SWAN): a prospective cohort study

Paramsothy

Harlow

Greendale

et al. 2014

BJOG

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“…73 In a Danish study of premenopausal and perimenopausal women, obesity was associated with higher frequency of flooding. 56 In the SWAN DHS, heavier women had shorter cycles than women with BMI <25kg/m 2 ; 43 but obesity was also associated with an increased number of heavy bleeding days. 17 The Harvard Study of Moods and Cycles found the age-adjusted incidence rate of perimenopause to be 1.58 times higher among obese women as compared to normal weight women.…”

Section: Factors That Influence Menstrual Characteristics During the mentioning

confidence: 96%

“…In a population-based menstrual calendar study of Danish women, onset of irregular cycles as women entered the menopausal transition was associated with increased variability in the duration of bleeding, with increased frequency of spotting and bleeds lasting 10 or more days and with increased variability in women’s subjective reports of the amount of menstrual flow. 56 …”

Section: Characteristics Of Menstrual Bleedingmentioning

confidence: 99%

Menstruation and the Menopausal Transition

Harlow

Paramsothy

2011

Obstetrics and Gynecology Clinics of North America

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SYNOPSIS This paper characterizes changes in menstrual bleeding during perimenopause, including bleeding changes that represent markers of the menopausal transition. Recent results from the Study of Women’s Health Across the Nation (SWAN), a multiethnic cohort study of midlife women, as well as data from other cohort studies of women in the midlife are reviewed. Emerging data describing subpopulation differences in the transition experience is highlighted . Early transition, defined as a persistent difference in consecutive menstrual cycle length of seven or more days, begins on average 6-8 years before the FMP. Late transition, defined by an episode of 60 or more days of amenorrhea, begins on average two years before the FMP. When treating women in the midlife, clinicians should pay careful attention to medical factors, including both conditions and treatments, that may increase menstrual blood loss or alter menstrual cycle characteristics sufficiently to obscure the onset of the menopausal transition or the FMP.

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The significance of “atrophic endometrium” in women with postmenopausal bleeding

Rotenberg

Goldberg

2022

Arch Gynecol Obstet

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Menstrual bleeding patterns in pre‐ and perimenopausal women: a population‐based prospective diary study

Abstract: Irregularity of cycle lengths at the end of the fertile period is common, and is accompanied by an increased inter- and intraindividual variation in the length and heaviness of bleeding episodes, including increased frequency of prolonged bleeding and spotting.

Cited by 17 publications

References 11 publications

Bleeding patterns during the menopausal transition in the multi‐ethnic Study of Women's Health Across the Nation (SWAN): a prospective cohort study

Bleeding patterns during the menopausal transition in the multi‐ethnic Study of Women's Health Across the Nation (SWAN): a prospective cohort study

Menstruation and the Menopausal Transition

The significance of “atrophic endometrium” in women with postmenopausal bleeding

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