Heavy menstrual bleeding and health-associated quality of life in women with von Willebrand's disease

Abstract

Women with the inherited bleeding disorder von Willebrand's disease (VWD) face gender-specific hemostatic challenges during menstruation. Heavy menstrual bleeding (HMB) can negatively affect their overall life activities and the health-associated quality of life. The purpose of the present study was to investigate whether women with VWD experienced HMB and an impaired health-associated quality of life. The study subjects were recruited from the Coagulation Unit of Karolinska University Hospital. Information was retrieved from various self-administered forms and medical records. Of the 30 women (18-52 years) that were included in the present study, 50% suffered from HMB, although the majority received treatment for HMB. In addition, almost all the included women perceived limitations in the overall life activities due to menstruation. The health-associated quality of life for women with HMB was significantly lower (P<0.10) with regards to 'bodily pain' compared with Swedish women of the general population. In conclusion, women with VWD experienced reduced health-associated quality of life as a result of HMB. Therefore, preventing limitations in overall life activities and improving their health-associated quality of life thorough counseling on menstrual bleeding is important for women with VWD.

Keywords: bleeding disorders; gynecology; heavy menstrual bleeding; hematology; quality of life; von Willebrand's disease.

Figure 1.

Impact of menstruation on overall life activities in the group of women with von Willebrand's disease and menstruation (n=22).

Figure 2.

Health profiles for the study population. Median SF-36 scores in each dimension of SF-36 presented as health profiles for the total study population and subgroups of the study population. (A) The health profile of the total study population compared with the health profile of Swedish women of the general population. Error bars represent the approximate confidence interval (P<0.10) for the median SF-36 scores of the study population. (B) The health profiles for women with VWD type 1, 2 and 3 compared with the health profile of Swedish women in the general population. (C) The health profiles of women with no menstrual bleeding, normal menstrual bleeding and HMB compared with the health profile of Swedish women in the general population. (D) The health profiles of women with HMB compared with the health profiles of Swedish women in the general population. Error bars represent the approximate confidence interval (P<0.10) for the median SF-36 scores of women with HMB. VWD, von Willebrand's disease; HMB, heavy menstrual bleeding; PF, Physical Functioning; RP, role-physical; BP, bodily pain; GH, general health; VT, vitality; SF, social functioning; RE, role-emotional; MH, mental health.