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:10.1080/j.0001-6349.2004.00401.x

Cited by 11 publications

(4 citation statements)

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“…However, males in our cohort reached a BS plateau with increasing age, whereas women tended to increase their BS. An explanation might be that women may also suffer from menorrhagia, postpartum bleeding or dysfunctional uterine bleeding during the perimenopausal period (28)(29)(30). The fact that the difference in age was limited to females could also be explained by historical reasons, as in the past less effective haemostatic interventions were used to prevent menorrhagia and postpartum haemorrhage (30).…”

Section: Discussionmentioning

confidence: 99%

Determinants of bleeding phenotype in adult patients with moderate or severe von Willebrand disease

et al. 2012

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We performed a nation-wide cross-sectional study to evaluate determinants of bleeding symptoms in a large unselected cohort of adults with von Willebrand disease (VWD). VWD patients were included (n=664), based on lowest historically measured VWF:Ag and VWF:Act levels ≤30 U/dl. Menorrhagia (85%), cutaneous bleeding (77%), bleeding from minor wounds (77%) and oral-cavity bleeding (62%) occurred most frequently. Higher age was associated with a higher bleeding score (BS), determined according to Tosetto, in females. A 10 year increase in age was associated with 0.8 point (95% confidence interval [CI] 0.4-1.1) higher BS. Females had higher BS than males (median 12 vs. 10, p=0.012). BS differed significantly between VWD type 1, 2 and 3: median 9 (-2-31), 13 (-1-33) and 19.5 (1-35), respectively (p<0.001). BS was strongly associated with VWF and FVIII levels: individuals with VWF:Ag levels ≤10 IU/dl, VWF:Act ≤10 IU/dl and FVIII:C ≤10 IU/dl had, respectively, 5.3 point (95%CI 3.2-7.3), 4.3 point (95%CI 2.9-5.8) and 9.6 point (95%CI 6.5-12.7) higher BS, than those with levels >30 IU/dl. In type 3 patients 1 IU/dl FVIII:C decrease was associated with 0.6 point (95% CI 0.1-1.1) BS increase (p=0.021). In conclusion, in VWD patients the bleeding phenotype is strongly associated with type of VWD and VWF and FVIII levels.

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Section: Discussionmentioning

confidence: 99%

Determinants of bleeding phenotype in adult patients with moderate or severe von Willebrand disease

et al. 2012

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“…Probably many women may choose LNG-IUS instead of undergoing surgical sterilization because this method not only provides contraception but also controls heavy menstrual bleeding (HMB), a common occurrence during menopausal transition. 24 Among women over 40 years of age, between 33 and 50% present complaints of abnormal bleeding or HMB. 24 Consequently, the that both LNG-IUS and DMPA reduce menstrual flow may have been one of the factors that encouraged women to keep using these methods until menopause.…”

Section: Discussionmentioning

confidence: 99%

“…24 Among women over 40 years of age, between 33 and 50% present complaints of abnormal bleeding or HMB. 24 Consequently, the that both LNG-IUS and DMPA reduce menstrual flow may have been one of the factors that encouraged women to keep using these methods until menopause. Sterilization does not improve menstrual patterns, which tend to be irregular during the final years of a woman's reproductive life.…”

Section: Discussionmentioning

confidence: 99%

The Use of Long Acting Reversible Contraceptives and the Relationship between Discontinuation Rates due to Menopause and to Female and Male Sterilizations

Ferreira

Monteiro

Castro

et al. 2016

Rev Bras Ginecol Obstet

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Introduction Women require effective contraception until they reach menopause. The long acting reversible contraceptives (LARC) and the depot-medroxyprogesterone acetate (DMPA, Depo-Provera®, Pfizer, Puurs, Belgium) are great options and can replace possible sterilizations. Purpose To assess the relationship between the use of LARCs and DMPA and terminations ascribed to menopause and sterilizations in a Brazilian clinic. Methods We reviewed the records of women between 12 and 50 years of age attending the clinic that chose to use a LARC method or DMPA. Cumulative termination rates due to sterilization or because the woman had reached menopause were computed using single decrement life-table analysis over 32 years. We also examined all records of surgical sterilization at our hospital between the years 1980-2012. Results Three hundred thirty-two women had continuously used the same contraceptive until menopause, and 555 women had discontinued the method because they or their partners underwent sterilization. From year 20 to year 30 of use, levonorgestrel intrauterine-releasing system (LNG-IUS -Mirena®, Bayer Oy, Turku, Finland; available since 1980), copper intrauterine device (IUD -available since 1980) and DMPA users showed a trend of cumulative higher discontinuation rates due to menopause when compared with the discontinuation rates due to sterilization. Over the study period, a steep decline in the use of sterilization occurred.

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“…If AE is really a cause of PMB, we would expect to see an increase in the incidence of PMB as women get older. However, the literature conclusively shows that the incidence of PMB decreases with increasing age (35)(36)(37) . 5) AE is ubiquitous in postmenopausal women, still over 90% of these women will not have PMB.…”

Section: )mentioning

confidence: 98%

The significance of “Atrophic Endometrium” in Women with Postmenopausal Bleeding.

Rotenberg

Goldberg

2020

Preprint

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We evaluated the interpretation of atrophic endometrium (AE) histology as a common cause for postmenopausal bleeding (PMB). In our opinion, AE is physiologic and ubiquitous in postmenopausal women, but is not a cause of PMB. Referring to AE as a cause of PMB may result in misdiagnosis of cancer and delay in management. Endometrial sampling are notorious for missing focal lesions and transvaginal sonogram should be considered in cases of PMB and AE histology. If endometrial thickness is found, it is not compatible with AE and further workup is warranted to exclude focal lesions which are common cause for PMB.

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

Cited by 11 publications

References 0 publications

Determinants of bleeding phenotype in adult patients with moderate or severe von Willebrand disease

Determinants of bleeding phenotype in adult patients with moderate or severe von Willebrand disease

The Use of Long Acting Reversible Contraceptives and the Relationship between Discontinuation Rates due to Menopause and to Female and Male Sterilizations

The significance of “Atrophic Endometrium” in Women with Postmenopausal Bleeding.

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