Quality of life during menstruation in patients with inherited bleeding disorders

Menorrhagia is a common and major problem for patients with inherited bleed ing disorders, especially vWD. Quality of life during menstruation was asse ssed in 99 patients with inherited bleeding disorders including vWD (n = 57 ), carriers of haemophilia A (n = 17), carriers of haemophilia B (n = 7) an d FXI deficiency (n = 18), and comparison was performed with an age-matched control group (n = 69). A questionnaire was used that included four main s ections: (i) general health, (ii) health and daily activities, (iii) dysmen orrhea and (iv) quality of life during the menstrual period. Although patie nts with inherited bleeding disorders felt that their health (in general) w as very good, they had significantly poorer quality of life on all the scal es used than controls. Thirty-nine per cent reported having cut down on the amount of time spent on work and other activities as a result of their men struation; 47% felt that they accomplished less than they would like during this period, 38% felt that they were limited in the kind of work and other activities that they could do, and 40% found that it took extra effort to perform their work. Fifty-one per cent experienced moderate, severe or very severe dysmenorrhoea. Quality of life was statistically poorer in patients with vWD, menstrual scores >100 according to the pictorial blood assessmen t chart (PBAC), those who had periods greater than or equal to 8 days and t hose who experienced flooding or passage of clots. In conclusion, menstruat ion has a negative effect on the quality of life in patients with inherited bleeding disorders especially in these with objectively confirmed menorrha gia.