Heavy Menstrual Bleeding Linked to Fatigue in Menopause

Edited By: Lora McGlade

TOPLINE: 

Women experiencing three or more episodes of heavy menstrual bleeding during the menopause transition face 62% higher odds of feeling tired. Greater clinical attention to bleeding changes and associated fatigue symptoms is warranted for better management.

METHODOLOGY:

• Longitudinal daily menstrual calendar data were collected from 2329 participants in the Study of Women’s Health Across the Nation to identify episodes of heavy menstrual bleeding and prolonged menstrual bleeding.
• Researchers assessed four symptoms of fatigue (worn out, feeling tired, full of pep, having energy) at seven annual follow-up visits.
• Analysis utilized general linear mixed models with random intercepts for each woman to evaluate associations between fatigue variables and bleeding patterns recorded during the 6 months prior to each annual follow-up visit.
• Models incorporated adjustments for race, ethnicity, age, BMI, hormone therapy use, depressive and anxiety symptoms, perceived stress, sleep problems, cigarette use, and discrimination.

TAKEAWAY:

• Women reporting three or more episodes of heavy menstrual bleeding in the prior 6 months showed increased odds of feeling tired (odds ratio [OR], 1.62; 95% CI, 1.11-2.38) and being worn out (OR, 1.44; 95% CI, 0.98-2.13).
• Analysis revealed that three or more episodes of prolonged menstrual bleeding in the prior 6-month window were associated with lower odds of being full of pep (OR, 0.68; 95% CI, 0.49-0.95).
• Heavy menstrual bleeding and prolonged menstrual bleeding during the menopause transition were linked to increased odds of experiencing three symptoms of fatigue.

IN PRACTICE: 

“Greater clinical attention to bleeding changes and associated symptoms, including fatigue and lack of energy, is warranted, as is education of women about potential health consequences of excessive menstrual bleeding during the menopause transition,” write the authors of the study.

SOURCE: 

The study was led by Siobán D. Harlow, PhD, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor. It was published online March 11 in the journal Menopause.

LIMITATIONS: 

Researchers acknowledged that they lacked sufficient information to permit clinical diagnoses of abnormal uterine bleeding. Additionally, the absence of measures for iron status prevented direct linking of low energy or fatigue to anemia, limiting the ability to determine whether the observed associations between symptoms and heavy or prolonged bleeding were mediated by anemia.

DISCLOSURES: 

The Study of Women’s Health Across the Nation received grant support from the National Institutes of Health through the National Institute on Aging, the National Institute of Nursing Research, and the NIH Office of Research on Women’s Health. Alain A. Mukwege, MD, MSc, disclosed having a past financial relationship with CVS. The other authors reported no relevant financial relationships.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.