Abnormal Uterine Bleeding and Venous Thromboembolism

Abnormal uterine bleeding (AUB) is very incidental in venous thromboembolism (VTE) and has a significant influence on quality of life (QoL), according to a recent study published in Blood Journal, that offers vital information on the incidence and impact of the condition in women of reproductive age using anticoagulants for VTE.

According to objective measurements of monthly blood loss and self-reported data, abnormal uterine bleeding (AUB) affects 10% to 30% of women of reproductive age. Although precise estimates of the incidence, frequency, and effects of anticoagulation-induced AUB are still not known, those who use oral anticoagulants have a significantly greater prevalence of the condition than those who do not. C.M.M. de Jong and team set out to collect high-quality prospective data on the prevalence, incidence, and relevance of AUB in women starting anticoagulant therapy because of acute venous thromboembolism in order to quantify the burden of AUB and identify unmet clinical needs in women receiving anticoagulant therapy (VTE).

The TEAM-VTE Research

The TEAM-VTE research involved women aged 18 to 50 who had been diagnosed with acute venous thromboembolism. It was an international multicenter prospective cohort study. Using visual blood loss assessment charts, menstrual blood loss was assessed at baseline for the last menstrual cycle prior to the diagnosis of VTE and prospectively for each cycle throughout the subsequent three to six months. AUB was characterized as a higher score (>100 or >150) on the graphical blood loss assessment chart or as self-reported AUB. The Menstrual Bleeding Questionnaire was used to evaluate the quality of life associated with AUB at both the baseline and follow-up points.

Key Findings

• The COVID-19 pandemic-related sluggish recruiting caused the trial to be stopped early.
• During follow-up, 65 (66%) of the 98 women satisfied at least one of the three categories of AUB.
• 60% of the women (36 of the 60) without AUB prior to the diagnosis of VTE experienced AUB.
• With a mean Menstrual Bleeding Questionnaire score rise of 5.1 points overall, QoL declined over time, although this decline in QoL was only seen in women with new-onset AUB.

Reference

de Jong, C. M. M., Blondon, M., Ay, C., Buchmuller, A., Beyer-Westendorf, J., Biechele, J., Bertoletti, L., Colombo, G., Donadini, M. P., Hendriks, S. V., Jara-Palomares, L., Nopp, S., Ruiz-Artacho, P., Stephan, P., Tromeur, C., Vanassche, T., Westerweel, P. E., & Klok, F. A. (2022). Incidence and impact of anticoagulation-associated abnormal menstrual bleeding in women after venous thromboembolism. In Blood (Vol. 140, Issue 16, pp. 1764–1773). American Society of Hematology. https://doi.org/10.1182/blood.2022017101