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A new study shows a significant proportion of Australian women experience heavy menstrual bleeding, with rates increasing as women age.
New research published in the Medical Journal of Australia has sought to determine the prevalence of heavy menstrual bleeding among women of reproductive age in Australia.
The study, which used data from the Australian Longitudinal Study on Women’s Health (ALSWH), found that rates of heavy menstrual bleeding increased with age, and are associated with significant impacts on quality of life.
Previously, heavy menstrual bleeding was defined as menstrual blood loss exceeding 80 mL per cycle, but recent criteria have moved to a more person-centred approach that considers individual perceptions of heavy bleeding, and the physical, social, emotional and material impacts experienced.
“In Australia, little is known about the prevalence of heavy menstrual bleeding across the reproductive lifespan, nor about the characteristics of women who experience this condition,” the authors wrote.
“The objectives of our study were to estimate the prevalence of self‐reported heavy menstrual bleeding from young adulthood to midlife in Australia, to investigate the characteristics of women who experience this condition, and to investigate the relationship of heavy menstrual bleeding with health‐related quality of life.”
Analysing decades of data
The researchers analysed ALSWH data from a cohort of women born between 1973 and 1978, who were surveyed approximately every three years for more than two decades.
Participants were asked, “In the last 12 months have you had heavy periods?” during each survey, with response options of “never”, “rarely”, “sometimes”, or “often.”
Health-related quality of life was assessed using the Medical Outcomes Study 36‐item short form health survey (SF‐36), which measures physical functioning, role‐limiting physical problems, bodily pain, general health, vitality, social functioning, role‐limiting emotional problems and mental health.
Of the 11 311 participants, 17.6% reported experiencing heavy bleeding at the age of 22 years, rising to 39.3% of women at age 48 years.
The likelihood of often experiencing heavy menstrual bleeding increased with higher BMI and was greatest among respondents with low iron levels or endometriosis.
It was also greater for women who did not have university degrees, formerly or currently smoked, reported no or low levels of physical activity, had given birth two or more times, had depressive symptoms, or reported diagnoses of hypertension or polycystic ovary syndrome.
“Mean health‐related quality of life scores for women who reported heavy menstrual bleeding were lower in all domains and for the summary mental health and physical health scores,” the authors wrote.
“Further, mean quality of life scores were lower for women who often experienced heavy menstrual bleeding than for women who sometimes experienced heavy bleeding.”
The use of intrauterine devices (IUDs) did not appear to significantly influence the likelihood of experiencing heavy menstrual bleeding, but the likelihood was lower for women using progestogen implants or other hormonal contraceptives.
Too many women going without treatment
The study findings are consistent with previous studies that showed a considerable proportion of women experiencing heavy menstrual bleeding, with the proportion increasing with age, and with substantial impact on quality of life reported.
“Despite the availability of effective treatments for heavy menstrual bleeding, which also improve health‐related quality of life, many women continue to live with symptoms,” the authors wrote.
“All women should be made aware of the range of treatments available, and provided access to care that is effective, empathetic, and reflects their values and preferences.”
Read the research in the Medical Journal of Australia.
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