Heavy menstrual bleeding in women on oral anticoagulants.

Thrombosis Research
Bethany Samuelson BannowAlison B Edelman

Abstract

Although heavy menstrual bleeding (HMB) is a known complication of anticoagulant therapy, rates of HMB in users of the direct oral anticoagulants (OACs) apixaban and rivaroxaban are largely unknown. We performed a retrospective cohort study of menstruating women prescribed rivaroxaban, apixaban and warfarin over a six-year period (2012-2018). The primary outcome was HMB requiring medical or surgical intervention. We used descriptive statistics and logistic regression to evaluate associations between OAC type, age, history of HMB, and the primary outcome. We identified 195 women of reproductive-age with a new therapeutic OAC prescription (62 on rivaroxaban, 54 on apixaban, 79 on warfarin). A minority (26/195, 13.3%) had a documented history of HMB, including 9 rivaroxaban users, 7 apixaban users and 10 warfarin users but most women (117/195, 60%) had no menstrual history documented. One third of subjects (64/195) required treatment for HMB within 6 months of starting OAC therapy. After controlling for a history of HMB, rivaroxaban users were 1.4 times more likely to require treatment as compared to users of other OACs. We found an association between rates of HMB necessitating medical or surgical intervention and rivaroxaban use...Continue Reading

References

Apr 2, 2010·American Journal of Preventive Medicine·Michele G BeckmanThomas L Ortel
Jul 5, 2013·Human Reproduction Update·UNKNOWN ESHRE Capri Workshop Group
Jan 30, 2015·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Ian S FraserFelice Petraglia
Aug 10, 2015·American Journal of Obstetrics and Gynecology·Linda D Bradley, Ndeye-Aicha Gueye
Jun 21, 2019·Journal of Thrombosis and Haemostasis : JTH·Ingrid M BistervelsSaskia Middeldorp
Oct 19, 2019·Research and Practice in Thrombosis and Haemostasis·Pamela L LutseyNeil A Zakai
Mar 21, 2020·Journal of the American College of Cardiology·Barbara S WigginsTy J Gluckman

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Citations

Jun 2, 2021·Deutsche medizinische Wochenschrift·Christina Hart, Birgit Linnemann
Jun 27, 2021·Contraception·Marissa LapedisSumathi Narayana
Aug 10, 2021·Research and Practice in Thrombosis and Haemostasis·Bethany Samuelson BannowPaula James

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