# Menstrual bleeding-specific quality of life in women on antiplatelet therapy

## TL;DR

This study found that antiplatelet therapy does not significantly increase menstrual blood loss or worsen quality of life in reproductive-aged women.

## Contribution

The study is the first to compare menstrual bleeding-specific quality of life and blood loss in women on antiplatelet therapy versus controls.

## Key findings

- Menstrual bleeding-specific quality of life was comparable between women on antiplatelet therapy and controls.
- Menstrual blood loss did not appear to be increased in women using antiplatelet drugs.

## Abstract

Antiplatelet therapy may affect menstrual blood loss in women of reproductive age.

To determine menstrual bleeding and related quality of life (QoL) in women on antiplatelet therapy.

We performed a cross-sectional study at a tertiary care center in the Netherlands, including women on antiplatelet therapy with an active menstrual cycle and a control group of reproductive-aged women who did not use antiplatelets. Participants completed an online questionnaire containing 2 validated instruments: (1) the Menstrual Bleeding Questionnaire (MBQ) to measure menstrual bleeding-specific QoL, and (2) the Pictorial Blood Loss Assessment Chart (PBAC). Scaled MBQ scores range from 0 to 100, with higher scores indicating worse QoL. A PBAC score of 100 is generally considered indicative of heavy menstrual bleeding.

In total, 38 women prescribed antiplatelet drugs (median age, 44 years [IQR, 40-48]) and 100 control women (median age, 35 years [IQR, 27-43]) completed the study questionnaire. Most common indication for antiplatelet therapy was stroke/transient ischemic attack (26%). Acetylsalicylic acid/carbasalate calcium (50%) and clopidogrel (37%) were most frequently used. Mean (SD) scaled MBQ scores were 18.9 (11.2) among antiplatelet drug users and 22.4 (10.9) in control women (adjusted mean difference, −3.28 [95% CI, −7.90, 1.35]). Median PBAC scores were 101.5 (IQR, 50.5-207) and 96.0 (IQR, 73.0-174.8; adjusted mean ratio, 0.784 [95% CI, 0.521, 1.18]), respectively. A PBAC score >100 was reported in 37% and 36% of the antiplatelet and control groups, respectively.

Menstrual bleeding-specific QoL was comparable between women on antiplatelet therapy and controls, although controls experienced a high burden of menstrual bleeding-related complaints. Menstrual blood loss did not seem to be increased.

•Antiplatelet therapy in women of reproductive age might affect menstrual blood loss.•We determined menstrual blood loss and quality of life in women with and without antiplatelet use.•Menstrual bleeding-specific quality of life was comparable between the 2 groups of women.•Menstrual blood loss was also comparable and not increased compared with reference values.

Antiplatelet therapy in women of reproductive age might affect menstrual blood loss.

We determined menstrual blood loss and quality of life in women with and without antiplatelet use.

Menstrual bleeding-specific quality of life was comparable between the 2 groups of women.

Menstrual blood loss was also comparable and not increased compared with reference values.