Menorrhagia and uterine artery blood flow

Menorrhagia is a significant problem in women of reproductive age. In half of the cases no specific aetiology is known. Vascular factors play a role b ut remain poorly understood. We chose to study whether any association exis ts between the flow impedance of uterine arteries and the amount of menstru al blood loss, The study population consisted of 60 spontaneously menstruat ing 35- to 49-year-old women without endometrial hyperplasia, polyps, or su bmucous fibroids, The pulsatility index (PI) from uterine arteries, arcuate arteries, and radial arteries was measured by transvaginal colour Doppler. Menstrual blood loss was measured by the alkaline haematin method. A signi ficant inverse correlation was found between uterine artery PI and the amou nt of menstrual blood loss, suggesting that women with lower uterine flow i mpedance bleed more. A regression model confirmed that this association was specific and not explained by uterine size, fibroids or any other of the 1 1 potential confounders included in the model. The correlation between uter ine artery PI and amount of menstrual blood loss suggests that vascular fac tors may be involved in the pathogenesis of menorrhagia.