The Prevalence and Impact of Heavy Menstrual Bleeding (Menorrhagia) in Elite and Non-Elite Athletes

Abstract

To identify the prevalence and impact of heavy menstrual bleeding (HMB) in exercising females where anemia may have a significant effect on training and performance a ‘Female Health Questionnaire’ was designed incorporating a validated diagnostic HMB series, demographics, exercise ability data, training status, anemia, iron supplementation and whether the menstrual cycle had affected training and performance. The survey was conducted in two stages; initially online, advertised via social media, and then repeated via face-to-face interviews with runners registered for the 2015 London Marathon. 789 participants responded to the online survey, and 1073 completed the survey at the marathon. HMB was reported by half of those online (54%), and by more than a third of the marathon runners (36%). Surprisingly, HMB was also prevalent amongst elite athletes (37%). Overall, 32% of exercising females reported a history of anemia, and 50% had previously supplemented with iron. Only a minority (22%) had sought medical advice. HMB is highly prevalent in exercising females, associated with self-reported anemia, increased use of iron supplementation and a perceived negative impact on performance. Further research is needed to investigate the impact of HMB, iron deficiency and anemia in exercising females.

Postoperative outcomes following cardiac surgery in non‐anaemic iron‐replete and iron‐deficient patients – an exploratory study

“…Piednoir et al found that a non-anaemic iron deficiency sub-group had greater transfusion rates (p < 0.05) after a broad range of cardiac surgical procedures [7]. The link between menstrual blood loss and iron deficiency in pre-menopausal women is well known [22,23]. This may be explained by our patient population, which focused on surgical procedures that carried a lower rate of blood loss (CABG and single valve surgery).…”

Participation in sports in relation to adolescent growth and development

“…Higher ghrelin and lower leptin secretion (related to lower FM) is associated with lower luteinizing hormone (LH) secretion in amenorrheic athletes compared to eumenorrheic athletes (32). Some studies have suggested that young female athletes have a higher prevalence of menstrual disorders (33,34) and that premenstrual syndrome (PMS) increases in prevalence with duration and intensification of competitive exercises in girls and young women (35). However, other studies have shown that physical activity can improve dysmenorrhea and decrease the need for analgesics for improving dysmenorrhea in women 18-28 years old (36).…”

Perspectives of women experiencing Menorrhagia: A descriptive qualitative study

“…For every three women with reproductive capabilities, at least one is estimated to be affected with menorrhagia (El‐Hemaidi, Gharaibeh, & Shehata, ). 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, ).…”

“…For every three women with reproductive capabilities, at least one is estimated to be affected with menorrhagia (El-Hemaidi, Gharaibeh, & Shehata, 2007). 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, 2017;Bruinvels, Burden, Brown, Richards, & Pedlar, 2016;Harlow & Campbell, 2000;Marsh et al, 2014).…”