Abstract
Objective
This study was designed to evaluate the effects of heavy menstrual bleeding (HMB) on the quality of life (QoL).
Methods
A prospective, observational study was conducted including 58 patients with HMB, aged 35 years or older, with a negative pregnancy test result, menstrual blood loss >80 ml, uterine volume up to 200 cc and negative endometrial biopsy. The QoL was evaluated by interview using the Short Form-36 (SF-36) questionnaire. Blood loss, measured by Pictorial Blood Loss Assessment Chart (PBAC), and hemoglobin levels were also assessed. Statistical analysis was performed using the Pearson coefficient correlation test.
Results
The age of the patients ranged from 35 to 52 years (42.8 ± 0.2 years). Increase in monthly expenses, negative implications in conjugal life, work impairment and health-care utilization due to HMB were seen in 96.5, 94.7, 66.7 and 59.6% of the patients, respectively. Hemoglobin levels correlated to SF-36 physical and mental composites scores (p = 0.020 and p = 0.027, respectively). PBAC score was not correlated with the QoL (physical composite score: p = 0.222 and mental composite score: p = 0.642) or with hemoglobin levels (r = −0.065; p = 0.278). Hemoglobin and QoL showed significant improvement after treatment (p < 0.001). Hemoglobin level was the only independent predictor of the QoL measured by SF-36 physical (p = 0.03) and mental (p = 0.04) composites scores.
Conclusions
HMB had significant repercussions in the social, medical and economic aspects of women. The impact on the QoL was associated with the hematimetric parameters.
Similar content being viewed by others
References
Association of Professors of Gynecology and Obstetrics (2002) Clinical management of abnormal uterine bleeding. APGO educational series. Association of Professors of Gynecology and Obstetrics, Crofton
Medical Data International, Inc. (1997) Gynecological surgery. MedPro Month
Clarke A, Black N, Rowe P et al (1995) Indications for and outcome of total abdominal hysterectomy for benign disease: a prospective cohort study. Br J Obstet Gynaecol 102:611–620
Davey PG, Duncan ID, Edward D, Scott AC (1988) Cost–benefit analysis of cephadrine and mezlocillin prophylaxis for abdominal and vaginal hysterectomy. Br J Obstet Gynaecol 95:1170–1177
Ando K, Morita S, Higashi T et al (2006) Health-related quality of life among Japanese women with iron-deficiency anemia. Qual Life Res 15:1559–1563
Dan AA, Martin LM, Crone C et al (2006) Depression, anemia and health-related quality of life in chronic hepatitis C. J Hepatol 44:491–498
Kallich J, McDermott A, Xu X, Fayers P, Cella D (2006) The relationship between patient knowledge of hemoglobin levels and health-related quality of life. Qual Life Res 15(1):57–68
Rannestad T (2005) Hysterectomy: effects on quality of life and psychological aspects. Best Pract Res Clin Obstet Gynaecol 19:419–430
Ware JE, Sherbourne CD (1992) The MOS 36-item short-form health status survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483
McHorney CA, Ware JE, Lu JFR (1994) The MOS 36-item short-form health survey (SF-36). III. Tests of data quality, scaling assumptions and reliability across diverse patient groups. Med Care 32:40–66
Higham J, O’Brian P, Shaw R (1990) Assessment of menstrual loss using a pictorial chart. Br J Obstet Gynaecol 97:734–739
Ciconelli RM, Ferraz MB, Santos W (1998) Tradução para a língua portuguesa e validação do questionário genérico de avaliação de qualidade de vida SF-36 (Brasil SF-36). Ver Bras Reumatol 39:143–150
Clark TJ, Khan KS, Foon R, Pattison H, Bryan S, Gupta JK (2002) Quality of life instruments in studies of menorrhagia: a systematic review. Eur J Obstet Gynecol Reprod Biol 104:96–104
Liu Z, Doan QV, Blumenthal P (2007) A systematic review evaluating health-related quality of life, work impairment, and health-care costs and utilization in abnormal uterine bleeding. Value Health 10:183–194
Kulkarni A, Lee CA, Griffeon A, Kadir RA (2006) Disorders of menstruation and their effect on the quality of life in women with congenital factor VII deficiency. Haemophilia 12:248–252
Busfield RA, Farquhar CM, Sowter MC et al (2006) A randomized trial comparing the intrauterine system and thermal balloon ablation for heavy menstrual bleeding. Br J Obstet Gynaecol 113:257–263
Hurskainen R, Teperi J, Rissanen P et al (2001) Quality of life and cost-effectiveness of levonorgestrel-releasing intrauterine system versus hysterectomy for treatment of menorrhagia: a randomised trial. Lancet 357:273–277
Silva-Filho AL, Werneck RA, Magalhães RS, Belo AV, Triginelli SA (2006) Abdominal vs vaginal hysterectomy: a comparative study of the postoperative quality of life and satisfaction. Arch Gynecol Obstet 274:21–24
Acknowledgment
We are very grateful to Bayer for sponsoring this investigation.
Conflict of interest statement
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
de Souza, S.S., Camargos, A.F., Ferreira, M.C.F. et al. Hemoglobin levels predict quality of life in women with heavy menstrual bleeding. Arch Gynecol Obstet 281, 895–900 (2010). https://doi.org/10.1007/s00404-009-1207-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-009-1207-9