Frontiers in Pharmacology (Jul 2022)

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

  • Jianmin Shan,
  • Jianmin Shan,
  • Hongjun Tian,
  • Chunhua Zhou,
  • Haibo Wang,
  • Xiaoyan Ma,
  • Ranli Li,
  • Haiping Yu,
  • Guangdong Chen,
  • Jingjing Zhu,
  • Ziyao Cai,
  • Chongguang Lin,
  • Langlang Cheng,
  • Yong Xu,
  • Sha Liu,
  • Congpei Zhang,
  • Qinghua Luo,
  • Yunshu Zhang,
  • Shili Jin,
  • Chuanxin Liu,
  • Qiuyu Zhang,
  • Luxian Lv,
  • Lei Yang,
  • Jiayue Chen,
  • Qianchen Li,
  • Wei Liu,
  • Weihua Yue,
  • Xueqin Song,
  • Chuanjun Zhuo,
  • Chuanjun Zhuo,
  • Chuanjun Zhuo,
  • Chuanjun Zhuo,
  • China; MODMD Group of China (CMODG)

DOI
https://doi.org/10.3389/fphar.2022.904908
Journal volume & issue
Vol. 13

Abstract

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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.

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