Abnormal Uterine Bleeding in Menopause Linked to Fatigue: Study

During the menopause transition, abnormal uterine bleeding, characterized by prolonged or heavy menstrual bleeding, occurs often. This study assessed whether prolonged or heavy menstrual bleeding was associated with fatigue.

Using daily menstrual calendar data from 2,329 participants in the Study of Women's Health Across the Nation, episodes of prolonged and heavy menstrual bleeding were identified. At seven annual follow-up visits, four symptoms of fatigue were evaluated: feeling worn out, feeling tired, having little pep, and lacking energy. Statistical models assessed the association between each fatigue symptom and prolonged or heavy menstrual bleeding recorded during the six months prior to each follow-up visit.

The models accounted for factors such as age, body mass index, hormone therapy use, depressive and anxiety symptoms, stress levels, sleep problems, smoking, and experiences of discrimination. After adjusting for these factors, reporting three or more episodes of heavy menstrual bleeding in the prior six months was associated with an increased likelihood of feeling tired and worn out. Similarly, experiencing prolonged menstrual bleeding three or more times in the prior six months was linked to lower energy levels. Both prolonged and heavy menstrual bleeding during the menopause transition were associated with increased fatigue.

Greater clinical attention to changes in menstrual bleeding and related symptoms, including fatigue and low energy, is important. Women should also be educated about the potential health consequences of excessive menstrual bleeding during this stage of life.

Reference:

Harlow, Siobán D.; Gold, Ellen B.; Hood, Michelle M.; Mukwege, Alain A.; Randolph, John F.; Greendale, Gail A. Abnormal uterine bleeding is associated with fatigue during the menopause transition. *Menopause* ():10.1097/GME.0000000000002525, March 11, 2025. | DOI: 10.1097/GME.0000000000002525.