How do anticoagulants impact menstrual bleeding and quality of life? - The PERIOD study

The “lived” experience of menstruating women commencing anticoagulants

“…With patients acting as their own control, the authors report that two-thirds of women newly prescribed anticoagulation therapy experienced HMB, which significantly affected their quality of life. These findings are replicated by the PERIOD study [ 2 ], which recruited 57 women commencing anticoagulation therapy and compared their experience with that of 109 women who acted as controls.…”

“…Women, aged 18 to 50 years, commencing anticoagulant therapy who had taken part in the parent PERIOD study [ 2 ] and had indicated in their returned questionnaire for the PERIOD study that they would be interested in taking part in an in-depth interview were approached to take part. Following informed written consent, a date was arranged with each volunteer to conduct the interview with the lead researcher (U.S.).…”

“…Details of the PERIOD study and its findings have been published elsewhere [ 2 ]; subjects were recruited from the anticoagulation clinics at King’s College Hospital NHS Foundation Trust, a 1500-bedded teaching hospital in Southeast London, United Kingdom.…”

Effects of antiplatelet therapy on menstrual blood loss in reproductive-aged women: a systematic review

“…The effects of oral anticoagulants on menstrual blood loss are better characterized and seem more pronounced than the effects of antiplatelet therapy. Several studies have reported that the use of oral anticoagulants, such as DOACs or VKAs, is associated with HMB, higher PBAC scores, and lower menstrual bleeding–specific quality of life [ 38 ]. A prospective cohort study among women with an active menstrual cycle who had a (recurrent) VTE and were treated with anticoagulants (87% DOACs and 12% VKAs) reported that during a 6-month follow-up period, 66% (95% CI, 57%-75%; 65/98 women) of women met at least once 1 of the criteria of the author’s definition of AUB (a PBAC score of >100 or self-reported increased menstrual volume) [ 4 ].…”

Venous thromboembolism among physically active young adult females

“…The prolonged use of anticoagulants has also been implicated in abnormal uterine bleeding, especially heavy menstrual bleeding, with detrimental effects on quality of life [ [9] , [10.] , [11] , [12] ]. The incidence of first VTE in a population-based study [ 13 ] conducted in Norway demonstrated a rate of 1.3 and 3.5 per 10,000 person-years in the 20 to 24 years age group for men and women, respectively, compared with 14.3 per 10,000 person-years in all the age groups (the general population).…”