Effects of anemia and iron deficiency on quality of life in women with heavy menstrual bleeding
Objective To assess the impact of anemia and iron deficiency on health‐related quality of life (HRQoL) in women treated for heavy menstrual bleeding (HMB). Design Secondary analysis of a randomized controlled trial. Setting Five university hospitals in Finland. Sample A total of 236 women referred f...
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| Veröffentlicht in: | Acta obstetricia et gynecologica Scandinavica 2014-07, Vol.93 (7), p.654-660 |
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| container_title | Acta obstetricia et gynecologica Scandinavica |
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| creator | Peuranpää, Pirkko Heliövaara-Peippo, Satu Fraser, Ian Paavonen, Jorma Hurskainen, Ritva |
| description | Objective
To assess the impact of anemia and iron deficiency on health‐related quality of life (HRQoL) in women treated for heavy menstrual bleeding (HMB).
Design
Secondary analysis of a randomized controlled trial.
Setting
Five university hospitals in Finland.
Sample
A total of 236 women referred for HMB.
Methods
Women were randomized to treatment with hysterectomy or a levonorgestrel‐releasing intrauterine system. We defined groups based on women's pretreatment hemoglobin [hemoglobin |
| doi_str_mv | 10.1111/aogs.12394 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1539463592</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1539463592</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4314-b0409d3bffbcd0ac83bf35d048dd020db97ea3863d6fec433d006a2545633e013</originalsourceid><addsrcrecordid>eNp9kEtP3TAQha2qVbml3fQHVJa6QZUC40ecZImu6C0FlQVFsLOceAymeYCdlObf4_QCiy46ixkf6Zuj8SHkI4N9lurADNdxn3FRyVdkxRRABpLx12QFACxTQlY75F2Mt0nxQpZvyQ6XFeOl5Cuij5zDZox0cNT02HmThqU-DD216HzjsW9mmtT9ZFo_zgvYeofU9_Rh6DB1P97QGzS_Z5pkHEMCad0iWt9fvydvnGkjfniau-Ti69HP9bfs9GxzvD48zRopmMxqkFBZUTtXNxZMU6anyC3I0lrgYOuqQCNKJaxK50ohLIAyPJe5EgKBiV2yt_W9C8P9hHHUnY8Ntm361DBFzfIUjxJ5xRP6-R_0dphCn65bKKWKAqrF8MuWasIQY0Cn74LvTJg1A73ErpfY9d_YE_zpyXKqO7Qv6HPOCWBb4MG3OP_HSh-ebc6fTbPtjo8j_nnZMeGXVoUocn35Y6Pzk6vL9ffNiebiEdD9m6Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1536677091</pqid></control><display><type>article</type><title>Effects of anemia and iron deficiency on quality of life in women with heavy menstrual bleeding</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Peuranpää, Pirkko ; Heliövaara-Peippo, Satu ; Fraser, Ian ; Paavonen, Jorma ; Hurskainen, Ritva</creator><creatorcontrib>Peuranpää, Pirkko ; Heliövaara-Peippo, Satu ; Fraser, Ian ; Paavonen, Jorma ; Hurskainen, Ritva</creatorcontrib><description>Objective
To assess the impact of anemia and iron deficiency on health‐related quality of life (HRQoL) in women treated for heavy menstrual bleeding (HMB).
Design
Secondary analysis of a randomized controlled trial.
Setting
Five university hospitals in Finland.
Sample
A total of 236 women referred for HMB.
Methods
Women were randomized to treatment with hysterectomy or a levonorgestrel‐releasing intrauterine system. We defined groups based on women's pretreatment hemoglobin [hemoglobin <120 g/L (anemic) vs. hemoglobin ≥120 g/L (nonanemic)] and serum ferritin (ferritin <15 μg/L vs. ≥15 μg/L) concentrations. HRQoL was compared between groups at baseline, 6 and 12 months after treatment. Hemoglobin and ferritin were followed for 5 years.
Main outcome measures
HRQoL was measured by the RAND 36‐item health survey (RAND‐36), 5‐Dimensional EuroQol and two questionnaires of mental wellbeing.
Results
At baseline, 63 women (27%) were anemic and 140 (60%) were severely iron deficient (ferritin <15 μg/L). Only 8% of the anemic women had taken iron supplementation. Twelve months after treatment hemoglobin had increased in both hemoglobin groups, but was still significantly lower (p < 0.001) in initially anemic women (128 g/L) compared with nonanemic women (136 g/L). Twelve months after treatment three domain scores of RAND‐36 increased more (energy, p = 0.002; physical functioning, p = 0.04; social functioning, p = 0.05), and anxiety (p = 0.02) and depression scores (p = 0.002) decreased more in anemic compared with nonanemic women. Serum ferritin took 5 years to reach normal levels.
Conclusions
Improved HRQoL after treatment of HMB is associated with correction of anemia. Clinicians should actively screen for anemia in women with HMB and emphasize early iron substitution as an integral part of treatment.</description><identifier>ISSN: 0001-6349</identifier><identifier>EISSN: 1600-0412</identifier><identifier>DOI: 10.1111/aogs.12394</identifier><identifier>PMID: 24912842</identifier><identifier>CODEN: AOGSAE</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Adult ; Anemia ; Anemia - drug therapy ; Anemia - etiology ; Anemia - psychology ; Anxiety - diagnosis ; Contraceptive Agents, Female - administration & dosage ; Depression - diagnosis ; Female ; Ferritins - analysis ; Follow-Up Studies ; heavy menstrual bleeding ; Hemoglobins - analysis ; Humans ; Hysterectomy - psychology ; Intrauterine Devices, Medicated ; Iron - deficiency ; Iron - therapeutic use ; Levonorgestrel - administration & dosage ; Linear Models ; menorrhagia ; Menorrhagia - complications ; Menorrhagia - drug therapy ; Menorrhagia - surgery ; Middle Aged ; Quality of Life ; Surveys and Questionnaires</subject><ispartof>Acta obstetricia et gynecologica Scandinavica, 2014-07, Vol.93 (7), p.654-660</ispartof><rights>2014 Nordic Federation of Societies of Obstetrics and Gynecology</rights><rights>2014 Nordic Federation of Societies of Obstetrics and Gynecology.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4314-b0409d3bffbcd0ac83bf35d048dd020db97ea3863d6fec433d006a2545633e013</citedby><cites>FETCH-LOGICAL-c4314-b0409d3bffbcd0ac83bf35d048dd020db97ea3863d6fec433d006a2545633e013</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Faogs.12394$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Faogs.12394$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24912842$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Peuranpää, Pirkko</creatorcontrib><creatorcontrib>Heliövaara-Peippo, Satu</creatorcontrib><creatorcontrib>Fraser, Ian</creatorcontrib><creatorcontrib>Paavonen, Jorma</creatorcontrib><creatorcontrib>Hurskainen, Ritva</creatorcontrib><title>Effects of anemia and iron deficiency on quality of life in women with heavy menstrual bleeding</title><title>Acta obstetricia et gynecologica Scandinavica</title><addtitle>Acta Obstet Gynecol Scand</addtitle><description>Objective
To assess the impact of anemia and iron deficiency on health‐related quality of life (HRQoL) in women treated for heavy menstrual bleeding (HMB).
Design
Secondary analysis of a randomized controlled trial.
Setting
Five university hospitals in Finland.
Sample
A total of 236 women referred for HMB.
Methods
Women were randomized to treatment with hysterectomy or a levonorgestrel‐releasing intrauterine system. We defined groups based on women's pretreatment hemoglobin [hemoglobin <120 g/L (anemic) vs. hemoglobin ≥120 g/L (nonanemic)] and serum ferritin (ferritin <15 μg/L vs. ≥15 μg/L) concentrations. HRQoL was compared between groups at baseline, 6 and 12 months after treatment. Hemoglobin and ferritin were followed for 5 years.
Main outcome measures
HRQoL was measured by the RAND 36‐item health survey (RAND‐36), 5‐Dimensional EuroQol and two questionnaires of mental wellbeing.
Results
At baseline, 63 women (27%) were anemic and 140 (60%) were severely iron deficient (ferritin <15 μg/L). Only 8% of the anemic women had taken iron supplementation. Twelve months after treatment hemoglobin had increased in both hemoglobin groups, but was still significantly lower (p < 0.001) in initially anemic women (128 g/L) compared with nonanemic women (136 g/L). Twelve months after treatment three domain scores of RAND‐36 increased more (energy, p = 0.002; physical functioning, p = 0.04; social functioning, p = 0.05), and anxiety (p = 0.02) and depression scores (p = 0.002) decreased more in anemic compared with nonanemic women. Serum ferritin took 5 years to reach normal levels.
Conclusions
Improved HRQoL after treatment of HMB is associated with correction of anemia. Clinicians should actively screen for anemia in women with HMB and emphasize early iron substitution as an integral part of treatment.</description><subject>Adult</subject><subject>Anemia</subject><subject>Anemia - drug therapy</subject><subject>Anemia - etiology</subject><subject>Anemia - psychology</subject><subject>Anxiety - diagnosis</subject><subject>Contraceptive Agents, Female - administration & dosage</subject><subject>Depression - diagnosis</subject><subject>Female</subject><subject>Ferritins - analysis</subject><subject>Follow-Up Studies</subject><subject>heavy menstrual bleeding</subject><subject>Hemoglobins - analysis</subject><subject>Humans</subject><subject>Hysterectomy - psychology</subject><subject>Intrauterine Devices, Medicated</subject><subject>Iron - deficiency</subject><subject>Iron - therapeutic use</subject><subject>Levonorgestrel - administration & dosage</subject><subject>Linear Models</subject><subject>menorrhagia</subject><subject>Menorrhagia - complications</subject><subject>Menorrhagia - drug therapy</subject><subject>Menorrhagia - surgery</subject><subject>Middle Aged</subject><subject>Quality of Life</subject><subject>Surveys and Questionnaires</subject><issn>0001-6349</issn><issn>1600-0412</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtP3TAQha2qVbml3fQHVJa6QZUC40ecZImu6C0FlQVFsLOceAymeYCdlObf4_QCiy46ixkf6Zuj8SHkI4N9lurADNdxn3FRyVdkxRRABpLx12QFACxTQlY75F2Mt0nxQpZvyQ6XFeOl5Cuij5zDZox0cNT02HmThqU-DD216HzjsW9mmtT9ZFo_zgvYeofU9_Rh6DB1P97QGzS_Z5pkHEMCad0iWt9fvydvnGkjfniau-Ti69HP9bfs9GxzvD48zRopmMxqkFBZUTtXNxZMU6anyC3I0lrgYOuqQCNKJaxK50ohLIAyPJe5EgKBiV2yt_W9C8P9hHHUnY8Ntm361DBFzfIUjxJ5xRP6-R_0dphCn65bKKWKAqrF8MuWasIQY0Cn74LvTJg1A73ErpfY9d_YE_zpyXKqO7Qv6HPOCWBb4MG3OP_HSh-ebc6fTbPtjo8j_nnZMeGXVoUocn35Y6Pzk6vL9ffNiebiEdD9m6Q</recordid><startdate>201407</startdate><enddate>201407</enddate><creator>Peuranpää, Pirkko</creator><creator>Heliövaara-Peippo, Satu</creator><creator>Fraser, Ian</creator><creator>Paavonen, Jorma</creator><creator>Hurskainen, Ritva</creator><general>Blackwell Publishing Ltd</general><general>John Wiley & Sons, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201407</creationdate><title>Effects of anemia and iron deficiency on quality of life in women with heavy menstrual bleeding</title><author>Peuranpää, Pirkko ; Heliövaara-Peippo, Satu ; Fraser, Ian ; Paavonen, Jorma ; Hurskainen, Ritva</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4314-b0409d3bffbcd0ac83bf35d048dd020db97ea3863d6fec433d006a2545633e013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Anemia</topic><topic>Anemia - drug therapy</topic><topic>Anemia - etiology</topic><topic>Anemia - psychology</topic><topic>Anxiety - diagnosis</topic><topic>Contraceptive Agents, Female - administration & dosage</topic><topic>Depression - diagnosis</topic><topic>Female</topic><topic>Ferritins - analysis</topic><topic>Follow-Up Studies</topic><topic>heavy menstrual bleeding</topic><topic>Hemoglobins - analysis</topic><topic>Humans</topic><topic>Hysterectomy - psychology</topic><topic>Intrauterine Devices, Medicated</topic><topic>Iron - deficiency</topic><topic>Iron - therapeutic use</topic><topic>Levonorgestrel - administration & dosage</topic><topic>Linear Models</topic><topic>menorrhagia</topic><topic>Menorrhagia - complications</topic><topic>Menorrhagia - drug therapy</topic><topic>Menorrhagia - surgery</topic><topic>Middle Aged</topic><topic>Quality of Life</topic><topic>Surveys and Questionnaires</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Peuranpää, Pirkko</creatorcontrib><creatorcontrib>Heliövaara-Peippo, Satu</creatorcontrib><creatorcontrib>Fraser, Ian</creatorcontrib><creatorcontrib>Paavonen, Jorma</creatorcontrib><creatorcontrib>Hurskainen, Ritva</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Acta obstetricia et gynecologica Scandinavica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Peuranpää, Pirkko</au><au>Heliövaara-Peippo, Satu</au><au>Fraser, Ian</au><au>Paavonen, Jorma</au><au>Hurskainen, Ritva</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of anemia and iron deficiency on quality of life in women with heavy menstrual bleeding</atitle><jtitle>Acta obstetricia et gynecologica Scandinavica</jtitle><addtitle>Acta Obstet Gynecol Scand</addtitle><date>2014-07</date><risdate>2014</risdate><volume>93</volume><issue>7</issue><spage>654</spage><epage>660</epage><pages>654-660</pages><issn>0001-6349</issn><eissn>1600-0412</eissn><coden>AOGSAE</coden><abstract>Objective
To assess the impact of anemia and iron deficiency on health‐related quality of life (HRQoL) in women treated for heavy menstrual bleeding (HMB).
Design
Secondary analysis of a randomized controlled trial.
Setting
Five university hospitals in Finland.
Sample
A total of 236 women referred for HMB.
Methods
Women were randomized to treatment with hysterectomy or a levonorgestrel‐releasing intrauterine system. We defined groups based on women's pretreatment hemoglobin [hemoglobin <120 g/L (anemic) vs. hemoglobin ≥120 g/L (nonanemic)] and serum ferritin (ferritin <15 μg/L vs. ≥15 μg/L) concentrations. HRQoL was compared between groups at baseline, 6 and 12 months after treatment. Hemoglobin and ferritin were followed for 5 years.
Main outcome measures
HRQoL was measured by the RAND 36‐item health survey (RAND‐36), 5‐Dimensional EuroQol and two questionnaires of mental wellbeing.
Results
At baseline, 63 women (27%) were anemic and 140 (60%) were severely iron deficient (ferritin <15 μg/L). Only 8% of the anemic women had taken iron supplementation. Twelve months after treatment hemoglobin had increased in both hemoglobin groups, but was still significantly lower (p < 0.001) in initially anemic women (128 g/L) compared with nonanemic women (136 g/L). Twelve months after treatment three domain scores of RAND‐36 increased more (energy, p = 0.002; physical functioning, p = 0.04; social functioning, p = 0.05), and anxiety (p = 0.02) and depression scores (p = 0.002) decreased more in anemic compared with nonanemic women. Serum ferritin took 5 years to reach normal levels.
Conclusions
Improved HRQoL after treatment of HMB is associated with correction of anemia. Clinicians should actively screen for anemia in women with HMB and emphasize early iron substitution as an integral part of treatment.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>24912842</pmid><doi>10.1111/aogs.12394</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0001-6349 |
| ispartof | Acta obstetricia et gynecologica Scandinavica, 2014-07, Vol.93 (7), p.654-660 |
| issn | 0001-6349 1600-0412 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1539463592 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Anemia Anemia - drug therapy Anemia - etiology Anemia - psychology Anxiety - diagnosis Contraceptive Agents, Female - administration & dosage Depression - diagnosis Female Ferritins - analysis Follow-Up Studies heavy menstrual bleeding Hemoglobins - analysis Humans Hysterectomy - psychology Intrauterine Devices, Medicated Iron - deficiency Iron - therapeutic use Levonorgestrel - administration & dosage Linear Models menorrhagia Menorrhagia - complications Menorrhagia - drug therapy Menorrhagia - surgery Middle Aged Quality of Life Surveys and Questionnaires |
| title | Effects of anemia and iron deficiency on quality of life in women with heavy menstrual bleeding |
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