Abnormal uterine bleeding during menopause transition linked to fatigue

Women experiencing heavy or prolonged menstrual bleeding during the menopause transition appear to be predisposed to fatigue, according to a study.

Researchers used longitudinal daily menstrual calendar data from the Study of Women's Health Across the Nation to identify episodes of heavy and prolonged menstrual bleeding. They also looked at four fatigue metrics—worn out, feeling tired, full of pep, having energy—at seven annual follow-up visits.

The association of each fatigue variable with heavy or prolonged menstrual bleeding during the 6 months prior to each annual follow-up visit was examined using general linear mixed models with random intercepts. The models were controlled for factors such as race and ethnicity, age, body mass index, hormone therapy use, depressive and anxiety symptoms, perceived stress, sleep problems, cigarette use, and discrimination.

Having at least three episodes of heavy menstrual bleeding in the past 6 months was associated with increased odds of feeling tired (odds ratio [OR], 1.62, 95 percent confidence interval [CI], 1.11–2.38) and being worn out (OR, 1.44, 95 percent CI, 0.98–2.13).

Meanwhile, having at least three episodes of prolonged menstrual bleeding in the previous 6 months was associated with reduced odds of being full of pep (OR, 0.68, 95 percent CI, 0.49–0.95).

The findings highlight the need to pay greater clinical attention to bleeding changes and associated symptoms, including fatigue and lack of energy, among women undergoing menopause transition, the researchers said.

These women will benefit from education about the potential health consequences of excessive menstrual bleeding during the transition, they added.