Hemoglobin levels predict quality of life in women with heavy menstrual bleeding

Arch Gynecol Obstet. 2010 May;281(5):895-900. doi: 10.1007/s00404-009-1207-9. Epub 2009 Aug 20.


Objective: This study was designed to evaluate the effects of heavy menstrual bleeding (HMB) on the quality of life (QoL).

Methods: A prospective, observational study was conducted including 58 patients with HMB, aged 35 years or older, with a negative pregnancy test result, menstrual blood loss >80 ml, uterine volume up to 200 cc and negative endometrial biopsy. The QoL was evaluated by interview using the Short Form-36 (SF-36) questionnaire. Blood loss, measured by Pictorial Blood Loss Assessment Chart (PBAC), and hemoglobin levels were also assessed. Statistical analysis was performed using the Pearson coefficient correlation test.

Results: The age of the patients ranged from 35 to 52 years (42.8+/-0.2 years). Increase in monthly expenses, negative implications in conjugal life, work impairment and health-care utilization due to HMB were seen in 96.5, 94.7, 66.7 and 59.6% of the patients, respectively. Hemoglobin levels correlated to SF-36 physical and mental composites scores (p=0.020 and p=0.027, respectively). PBAC score was not correlated with the QoL (physical composite score: p=0.222 and mental composite score: p=0.642) or with hemoglobin levels (r=-0.065; p=0.278). Hemoglobin and QoL showed significant improvement after treatment (p<0.001). Hemoglobin level was the only independent predictor of the QoL measured by SF-36 physical (p=0.03) and mental (p=0.04) composites scores.

Conclusions: HMB had significant repercussions in the social, medical and economic aspects of women. The impact on the QoL was associated with the hematimetric parameters.

MeSH terms

  • Adult
  • Female
  • Hemoglobins / metabolism*
  • Humans
  • Menorrhagia / metabolism
  • Menorrhagia / psychology*
  • Middle Aged
  • Prospective Studies
  • Quality of Life*


  • Hemoglobins