141 Evaluating the prevalence of heavy menstrual bleeding (menorrhagia) in patients with systemic lupus erythematosus

Abstract

Background: Heavy menstrual bleeding (HMB), or menorrhagia, is a leading cause of iron deficiency in females and ultimately results in anaemia. Previous studies have suggested that HMB affects 27% of the general population. Given that the majority of patients with systemic lupus erythematosus (SLE) are women of childbearing age it is important to assess for the burden of HMB in these patients. This study aims to identify the prevalence of HMB symptoms in patients with SLE. Methods: Between May 2017 and October 2017, patients fulfilling revised ACR criteria diagnosis of SLE were asked to complete a female health questionnaire based upon a similar validated questionnaire that has been used to assess for the prevalence of HMB in large population based studies. Patients were asked to self report if they had any symptoms suggestive of HMB. A diagnosis of HMB was given in two or more of the following four criteria were met: passing of large blood clots; need for double sanitary protection; need for frequent changes in tampons or towels (every two hours or less); and flooding to clothes/bedding. In addition, patients were asked to report the number of menstrual periods they had within the previous 12 months. Furthermore, patients were asked to report as to whether they had previously sought help for HMB in the past. Patients were also asked whether they had previously been told that they were anaemic and if this was treated with iron supplementation (either orally or via intravenous infusion). Results: A total of 107 patients completed the questionnaire (with ages ranging between 17-82 years old; median 42; IQR 32-52). 51% of patients reported that they had been told they were anaemic in the past. Of those who had been treated with iron supplementation 75% were given oral iron therapy (11% received intravenous iron and 14% had combined oral and intravenous treatment). 35% reported that they had previously sought medical attention for HMB. 68 of the patients who responded reported to having had at least one menstrual period in the last 12 months (this group was aged 17-51 years old). 46% reported a regularly monthly cycle. 41% of those still menstruating reported two or more of the four symptoms described and thus were consistent with a diagnosis of HMB. 25% reported all four symptoms of HMB. Conclusion: The prevalence of HMB in this cohort of patients with SLE (41%) is significantly higher than those seen in the general population (27%). This is important to consider as it confers a greater risk of iron deficiency.