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PS8:155 The prevalence of heavy menstrual bleeding (menorrhagia) in patients with systemic lupus erythematosus (sle)
  1. C Wincup1,
  2. T Richards2 and
  3. A Rahman1
  1. 1Department of Rheumatology, University College London, UK
  2. 2Centre for CardioVascular and Interventional Research (CAVIAR), Division of Surgery, University College London, UK


Background Heavy menstrual bleeding (HMB) affects 27% of the general female population and may ultimately result in iron deficiency and anaemia. Given that systemic lupus erythematosus (SLE) predominantly affects women of childbearing age it is important to consider the burden of HMB in these patients.

Purpose To identify the prevalence of HMB in pre-menopausal women with SLE.

Methods From May 2017, female patients fulfilling revised ACR criteria diagnosis of SLE were asked to complete a health questionnaire including sections on anaemia and menstrual history based upon a similar validated questionnaire that has previously been used in other previous large studies to assess for HMB prevalence. Patients were considered to have HMB if two or more of the following criteria were met;

  • passing of large blood clots,

  • need for double sanitary protection,

  • need for frequent changes of tampons or towels (every 2 hours or less),

  • flooding to clothes/bedding.

Patients were also asked how many menstrual periods they had in the previous 12 months and whether they had sought medical help for HMB before.

Results A total of 107 patients completed the questionnaire (Age range 17–82; median 42; IQR 32–52). For the purpose of this study we included only the 68 patients who reported having at least one menstrual period in the last 12 months (Age range 17–51; median 35; IQR 29–40). The majority (31/68; 46%) had 12 periods in the previous year and only 9/68 (13%) had less than 6 periods in that time. Over a third (24/68; 35%) reported they had sought help for symptoms of HMB in the past. Of the 68 patients who had atlas one menstrual period in the last year; 41% (28/68) reported two or more of the features that would fit with a diagnosis of HMB; see figure 1. The prevalence of each of the four risk factors is summarised in figure 2.

Conclusions The prevalence of HMB in women with lupus (41%) is higher than in previous studies of the general population (27%) thus increasing the risk of iron deficiency.

Abstract PS8:155 Figure 1

Total number of risk factors for HMB in all menstruating patients

Abstract PS8:155 Figure 2

Individual risk factors for HMB in all menstruating patients. A. passing of large blood clots, B. need for double sanitary protection, C. need for frequent changes of tampons or towels, D. flooding to clothes/bedding

  • Iron Deficiency
  • Heavy Menstrual Bleeding
  • Lupus

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