Review of quality of life: menorrhagia in women with or without inherited bleeding disorders

Abstract

The objectives of this study were to identify the impact of menorrhagia on the health-related quality of life (HRQOL) of women in general and those with inherited bleeding disorders and to identify the commonly used tools in assessing quality of life. A review of studies evaluating quality of life in women suffering from menorrhagia was conducted. Data sources used included electronic databases Medline and Embase. Reference lists and bibliographies of the relevant papers and books were hand-searched for additional studies. Eighteen of the 53 studies identified measured quality of life prior to treatment of menorrhagia. Ten of the studies used a validated measure of quality of life. Five studies involving a total of 1171 women with menorrhagia in general and using SF-36 were considered for further review. The mean SF-36 scores in women with menorrhagia were worse in all the eight scales when compared with normative scores from a general population of women. Three studies, involving 187 women, assessed the quality of life in women with menorrhagia and inherited bleeding disorders. None of these studies used a validated HRQOL score making it difficult for comparison. However, all reported poorer scores in study women compared to the controls. In conclusion, HRQOL is adversely affected in women with menorrhagia in general and in those with inherited bleeding disorders. HRQOL evaluation is useful in the management of women with menorrhagia for assessment of treatment efficacy.

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

“…Historically, patient-reported outcomes have not been the primary focus of HMB clinical trials 2 . Although modern trials are more apt to include patient-reported outcome measures, lack of a standard, disease-specific instrument makes interpretation of the results more challenging 9,10 . Determining minimally important changes in HMB has the most relevance for pharmacologic HMB therapies (e.g., hormonal therapies, competitive plasminogen inhibitors, anti-inflammatory drugs), as other treatment options such as hysterectomy or endometrial ablation eliminate or radically diminish MBL 11 .…”

Menorrhagia Impact Questionnaire: assessing the influence of heavy menstrual bleeding on quality of life

“…Certain questions on nonspecific QOL instruments, such as the Short Form 36 (SF-36), lack relatability for patients with HMB, thus making them suboptimal tools for this population [11][12][13] . Shortcomings in standardized QOL measures have led to a proliferation of questionnaires, although their validity and reliability have not been fully documented 10,12 . Numerous instruments for measuring health outcomes in menorrhagia research have been developed [14][15][16][17] .…”

“…A practical diagnosis of HMB is excessive MBL that is not tolerated by the patient and negatively affects her QOL. The most appropriate methodology and tool for evaluating QOL in patients with HMB continues to be a subject of debate 10 . Certain questions on nonspecific QOL instruments, such as the Short Form 36 (SF-36), lack relatability for patients with HMB, thus making them suboptimal tools for this population [11][12][13] .…”

A comparative study of tranexamic acid and ethamsylate in menorrhagia

“…[3][4][5][6] Nonsteroidal antiinflammatory drugs, hormonal treatment and surgical procedures can effectively reduce menstrual blood loss; however, variable efficacy, relative contraindications, potential adverse effects, or undesired effects on fertility can limit the use of these therapies. 7 Most patients complaining of menorrhagia have no detectable pelvic disease and are diagnosed as cases of dysfunctional uterine bleeding.…”