Heavy Menstrual Bleeding is a symptom caused by one or a combination of different local uterine or systemic abnormalities.

 

The interdependence of HMB and ID/IDA and their composite adverse impact on the health and function of adolescents and women of reproductive age, not only burden the individuals themselves, but insidiously undermine the efforts and function of educators, employers, healthcare providers, healthcare systems, governments and society at large.

WHrC’s goals are to create an effective HMB ID/IDA disease awareness and education initiative, add to the available evidence, and to encourage the development of management guidelines and practice models for the spectrum of involved health care providers.

Challenges Due to HMB ID/IDA

shutterstock_207683152.jpg

Awareness Issues

  • Social, cultural and emotional factors contribute to recognition of unmet need

    • 2/3 of women do not seek help for their heavy bleeding

    • 7.8% of women with chronic anemia reported their menstrual bleeding as “normal”1

    • Over half of marathoners surveyed had symptom of HMB, 1/3 had history of anemia and just over 20% ever sought medical advice9

  • Complete health and menstrual history evaluations are not always being performed

  • HCP frequently do not believe women’s HMB could result in very low hemoglobin levels therefore dismiss the correlation
shutterstock_1745547380.jpg

Burden of Illness

  • 40.5% of women with chronic HMB require blood transfusions1
  • 34-94% experience pain during their menstrual period2
  • 7.7% to 57.8% of adolescents miss school days because of menstrual issues2
  • 21.5% report missing out on social activities2
  • 1 in 3 women quit daily activities due to menstrual symptoms3
  • 77% of women complain of psychological symptoms3
  • 71% of women complain of fatigue3
shutterstock_1477334027.jpg

Economic Impact

  • Women in the workplace missed work 28% of the time more than women with normal menstrual bleeding 4
  • Average productivity loss is 33% or 8.9 days per woman, per year5
  • Annual personal care products and medications pose an economic burden to woman5
  • 1 in 3 women undergo hysterectomy in the US, half are due to HMB6
  • Indirect costs in the US (2007) were estimated to be $32 billion7

References

1Nelson AL, Ritchie JJ. Severe anemia from heavy menstrual bleeding requires heightened attention. Am J Obstet Gynecol. 2015;213(1):97 e1- e6.

2De Sanctis V, Soliman A, Bernasconi S, Bianchin L, Bona G, Bozzola M, et al. Primary Dysmenorrhea in Adolescents: Prevalence, Impact and Recent Knowledge. Pediatr Endocrinol Rev. 2015;13(2):512-20.

3Schoep ME, Nieboer TE, van der Zanden M, Braat DDM, Nap AW. The impact of menstrual symptoms on everyday life: a survey among 42,879 women. Am J Obstet Gynecol. 2019;220(6):569 e1- e7.

4Cote I, Jacobs P, Cumming DC. Use of health services associated with increased menstrual loss in the United States. Am J Obstet Gynecol. 2003;188(2):343-8.

5Frick KD, Clark MA, Steinwachs DM, Langenberg P, Stovall D, Munro MG, et al. Financial and quality-of-life burden of dysfunctional uterine bleeding among women agreeing to obtain surgical treatment. Womens Health Issues. 2009;19(1):70-8.
6Whiteman MK, Hillis SD, Jamieson DJ, Morrow B, Podgornik MN, Brett KM, et al. Inpatient hysterectomy surveillance in the United States, 2000-2004. Am J Obstet Gynecol. 2008;198(1):34 e1-7.

7Liu Z, Doan QV, Blumenthal P, Dubois RW. A systematic review evaluating health-related quality of life, work impairment, and health-care costs and utilization in abnormal uterine bleeding. Value Health. 2007;10(3):183-94.

8Schoep ME, Adang EMM, Maas JWM, De Bie B, Aarts JWM, Nieboer TE. Productivity loss due to menstruation-related symptoms: a nationwide cross-sectional survey among 32 748 women. BMJ Open. 2019;9(6):e026186.

9Bruinvels G, Burden R, Brown N, Richards T, Pedlar C. The Prevalence and Impact of Heavy Menstrual Bleeding (Menorrhagia) in Elite and Non-Elite Athletes. PloS one. 2016;11(2):e0149881.
 

Heavy Menstrual Bleeding ID/IDA
Steering Committee

DrMUNRO250.png

Malcom G. Munro, MD, FRCSC, FACOG   
Chair, FIGO Menstrual Disorders Committee
Co-Chair, SEUD Abnormal Uterine Bleeding Task Force
Voluntary Clinical Professor
David Geffen School of Medicine, UCLA

DrKouides.png

Peter Kouides, MD
Attending Staff Hematologist | Rochester Regional Health
Professor of Medicine | University of Rochester School of Medicine and Dentistry
Medical and Research Director, Mary M. Gooley Hemophilia Treatment Center
Immediate Past-President, Thrombosis and Hemostasis Societies of North America
Rochester General Hospital | 1425 Portland Ave | Rochester NY 14621

Photo-MLavin-250X250.png

Michele Lavin, MB BCh BAO, PhD, MRCPI, FRCPath
Consultant Hematologist, National Coagulation Centre, St. James’ Hospital, Dublin
Principal Investigator, Irish Centre for Vascular Biology, RCSI, Dublin, Ireland

BLevy.jpg

Barbara Levy, MD, FACOG, FACS
Voluntary Clinical Professor of Obstetrics, Gynecology and Reproductive Sciences, UCSD Health
Clinical Professor at the George Washington University School of Medicine and Health Sciences

DrMAST.png

Alan Mast, MD, PhD
Senior Investigator
Walter A. Schroeder Endowed Chair for Blood Research
Versiti Blood Research Institute
Milwaukee, WI

DrOBRIEN.png

Sarah O’Brien, MD
Ohio State University

DrPOWERS.png

Michelle Powers, MD, MS
Texas Children’s Hospital

DrRICHARDS.png

Toby Richards, MD, FRCS
University of Western Australia