Prevalence of Heavy Menstrual Bleeding and Its Associated Cognitive Risks and Predictive Factors in Women With Severe Mental Disorders

• Main Authors: Jianmin Shan (Author), Hongjun Tian (Author), Chunhua Zhou (Author), Haibo Wang (Author), Xiaoyan Ma (Author), Ranli Li (Author), Haiping Yu (Author), Guangdong Chen (Author), Jingjing Zhu (Author), Ziyao Cai (Author), Chongguang Lin (Author), Langlang Cheng (Author), Yong Xu (Author), Sha Liu (Author), Congpei Zhang (Author), Qinghua Luo (Author), Yunshu Zhang (Author), Shili Jin (Author), Chuanxin Liu (Author), Qiuyu Zhang (Author), Luxian Lv (Author), Lei Yang (Author), Jiayue Chen (Author), Qianchen Li (Author), Wei Liu (Author), Weihua Yue (Author), Xueqin Song (Author), Chuanjun Zhuo (Author), China; MODMD Group of China (CMODG) (Author)
• Format: Book
• Published: Frontiers Media S.A., 2022-07-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 1663-9812; 10.3389/fphar.2022.904908
• Keywords: bipolar disorder; major depressive disorder; schizophrenia; heavy menstrual bleeding; visual learning; lithium; Therapeutics. Pharmacology; RM1-950
• Source: Frontiers in Pharmacology, Vol 13 (2022)

There has been limited studies examining treatment-induced heavy menstrual bleeding (HMB) in women with severe mental illnesses. The aim of this study was to examine HMB prevalence and HMB-associated factors in young women (18-34 years old) diagnosed with bipolar disorder (BP), major depressive disorder (MDD), or schizophrenia (SCZ) who have full insight and normal intelligence. Eighteen-month menstruation histories were recorded with pictorial blood loss assessment chart assessments of HMB. Multivariate analyses were conducted to obtain odds ratios (ORs) and 95% confidence intervals (CIs). Drug effects on cognition were assessed with the MATRICS Consensus Cognitive Battery (MCCB). HMB prevalence were: BP, 25.85%; MDD, 18.78%; and SCH, 13.7%. High glycosylated hemoglobin (HbA1c) level was a strong risk factor for HMB [BP OR, 19.39 (16.60-23.01); MDD OR, 2.69 (4.59-13.78); and SCZ OR, 9.59 (6.14-12.43)]. Additional risk factors included fasting blood sugar, 2-h postprandial blood glucose, and use of the medication valproate [BP: OR, 16.00 (95%CI 12.74-20.22); MDD: OR, 13.88 (95%CI 11.24-17.03); and SCZ OR, 11.35 (95%CI 8.84-19.20)]. Antipsychotic, antidepressant, and electroconvulsive therapy use were minor risk factors. Pharmacotherapy-induced visual learning impairment was associated with HMB [BP: OR, 9.01 (95%CI 3.15-13.44); MDD: OR, 5.99 (95%CI 3.11-9.00); and SCZ: OR, 7.09 (95%CI 2.99-9.20)]. Lithium emerged as a protective factor against HMB [BP: OR, 0.22 (95%CI 0.14-0.40); MDD: OR, 0.30 (95%CI 0.20-0.62); and SCZ: OR, 0.65 (95%CI 0.33-0.90)]. In SCZ patients, hyperlipidemia and high total cholesterol were HMB-associated factors (ORs, 1.87-2.22). Psychiatrist awareness of HMB risk is concerningly low (12/257, 2.28%). In conclusion, prescription of VPA should be cautioned for women with mental illness, especially BP, and lithium may be protective against HMB.