Quality of Life (QoL) Evaluation in Women with Menorrhagia and Inherited Bleeding Disorders

Abstract number: P0258

Dowling¹ NF, Byams¹ VR, Miller¹ CH, Heit² JA, Kouides³ PA, Philipp⁴ CS, Stein⁵ SF, Kulkarni⁶ R, Lukes⁷ A, Crudder¹ S

¹¹Division of Hereditary Blood Disorders, Centers for Disease Control and Prevention, Atlanta, GA, USA ¹¹Division of Hereditary Blood Disorders, Centers for Disease Control and Prevention, Atlanta, GA, USA ²²Mayo Clinic, Rochester, MN, USA ³³University of Rochester School of Medicine, Rochester, NY, USA ⁴⁴Robert Wood Johnson Medical School, New Brunswick, NJ, USA ⁵⁵Emory University School of Medicine, Atlanta, GA, USA ⁶⁶Michigan State University, E. Lansing, MI, USA ⁷⁷Duke University, Durham, NC, USA

The effect of menorrhagia on activities and perceptions of health has yet to be quantified in American women with and without an underlying bleeding disorder using the Health Related Quality of Life (HRQOL) instrument.

Objective:  To characterize Quality of Life (QoL), using the validated HRQOL, in women ages 18–50 with unexplained menorrhagia undergoing screening for enrollment in a multi-site treatment and management trial.

Methods:  Menorrhagia was defined as a Pictorial Blood Assessment Chart (PBAC) score >=100. The Centers for Disease Control and Prevention developed the HRQOL to measure over a 30 day interval the number of days perceived as physically or mentally unhealthy or with limited activity. HRQOL data have been collected on over 1 million US adults through the Behavioral Risk Factor Surveillance Survey.

Results:  Of 125 women with menorrhagia completing a baseline HRQOL instrument, the mean number of physically unhealthy days was 4.9 compared with 3.5 for women in the U.S general population. The mean number of mentally unhealthy days among women with menorrhagia was twice that of the general population; 7.1 days and 3.3 days, respectively. Activity limitation was also greater among study women with menorrhagia, with a mean of 3.3 days vs. 1.8 days in the female population. Sixteen (14%) women were classified as possible or definite von Willebrand Disease (VWD) and 40 (32%) as no laboratory abnormality. Women with menorrhagia and VWD had on average 5.5 days of activity limitation compared with 3.4 days for women with menorrhagia but no diagnosed bleeding disorder (P= 0.7, Wilcoxon Rank Sum); no differences were observed in numbers of physically or mentally unhealthy days.

Conclusion:  These preliminary data suggest that women with menorrhagia have reduced physical and mental health compared to the US female population. The suggestion of activity limitation for women with VWD deserves further evaluation.