In women of reproductive age using anticoagulants, preliminary data and clinical experience had revealed an increased risk of abnormal uterine bleeding (AUB), but more conclusive evidence was needed. A multinational, multicenter prospective cohort research called TEAM-VTE examined women between the ages of 18 and 50 who had been diagnosed with acute venous thromboembolism (VTE). 

Using visual blood loss assessment charts, menstrual blood loss was assessed at baseline for the last menstrual cycle before the diagnosis of VTE and prospectively for each cycle throughout the subsequent three to six months. AUB was characterized as a higher score (>100 or >150) on the graphical blood loss assessment chart or as self-reported AUB. Using the Menstrual Bleeding Questionnaire, the quality of life (QoL) associated with AUB was evaluated at baseline and the conclusion of the follow-up. The COVID-19 pandemic-related sluggish recruiting caused the trial to be stopped early. 

During follow-up, 65 (66%) of the 98 women met at least 1 of the 3 criteria of AUB (95% CI, 57%-75%). About 60% of the women (36 of 60) who did not have AUB prior to the diagnosis of VTE developed it (new-onset AUB; 95% CI, 47%-71%). With a mean Menstrual Bleeding Questionnaire score rise of 5.1 points (95% CI, 2.2-7.9), QoL declined overall with time, although the decline in QoL was only seen in women with new-onset AUB. 

In conclusion, AUB affected QoL significantly in 2 out of 3 women who began anticoagulation for acute VTE. The results should catalyze action to raise awareness and offer research-supported prevention and treatment options for AUB in the environment.

Reference: ashpublications.org/blood/article/140/16/1764/486115/Incidence-and-impact-of-anticoagulation-associated