LAUSR

Preliminary data and clinical experience have suggested an increased risk of abnormal uterine bleeding (AUB) in women of reproductive age treated with anticoagulants, but solid data are lacking. The TEAM-VTE study was an international, multicentre, prospective cohort study in women aged 18-50 diagnosed with acute venous thromboembolism (VTE). Menstrual blood loss was measured by Pictorial Blood Loss Assessment Charts (PBAC) at baseline for the last menstrual cycle before VTE diagnosis and prospectively for each cycle during three-six month follow-up. AUB was defined as an elevated PBAC score (>100 or >150) or self-reported AUB. AUB-related quality of life (QoL) was assessed at baseline and end of follow-up using the Menstrual Bleeding Questionnaire (MBQ). The study was terminated early because of slow recruitment due to the pandemic. Of the 98 women, 65 (66%) met at least one of the three definitions of AUB during follow-up (95% confidence interval (CI) 57-75%). AUB occurred in 60% (36/60) of women without AUB before VTE diagnosis ('new-onset' AUB; 95%CI 47-71%). Overall, QoL decreased over time with a mean MBQ increase of 5.1 points (95%CI 2.2-7.9), but this decrease in QoL was only observed among women with new-onset AUB. To conclude, two out of three women who start anticoagulation for acute VTE suffer from AUB, with a considerable negative impact on QoL. These findings should be a call to action to increase awareness and provide evidence-based strategies for preventing and treating AUB in this setting. This was an academic study (NCT04748393 at www.clinicaltrials.gov); no funding was received.