Key result
Antithrombotic therapy linked to ~12-point increase in abnormal menstrual cycles.
Why the study?
Abnormal uterine bleeding is a clinically important yet often overlooked concern during cardiovascular antithrombotic therapy, prompting this study to describe paired menstrual changes and explore bleeding variation across anticoagulant and antiplatelet regimens.
Does cardiovascular antithrombotic therapy alter menstrual-cycle category and menstrual duration in menstruating women aged 18–55 years?
Observational (n=50)
Does cardiovascular antithrombotic therapy alter menstrual-cycle category and menstrual duration in menstruating women aged 18–55 years?
Cardiovascular antithrombotic therapy in menstruating women is associated with significant increases in abnormal menstrual cycles and prolonged menses, with the highest bleeding rates observed in rivaroxaban recipients.
May signal menstrual effects in this small cohort; leaves open need for confirmation before any monitoring or practice implications.
Background: Abnormal uterine bleeding is a clinically important but often overlooked concern during antithrombotic therapy, particularly in cardiovascular care where anticoagulant and antiplatelet regimens are used. Objective: To describe paired menstrual changes during cardiovascular antithrombotic therapy and to explore documented increased or prolonged bleeding across treatment classes and observed regimens. Methods: This prospective observational paired clinical follow-up study included 50 menstruating women aged 18–55 years with regular menses who received antithrombotic therapy for cardiovascular conditions. Source records specified monthly follow-up and at least 3 months of anticipated treatment. Primary outcomes were paired changes in menstrual-cycle category and menstrual duration; documented increased or prolonged bleeding and variation across observed regimens were secondary exploratory outcomes. Results: Abnormal menstrual-cycle categories increased from 8/50 (16.0%) to 14/50 (28.0%), and prolonged menses increased from 2/49 (4.1%) to 8/49 (16.3%); both exact McNemar P=0.031. Documented increased or prolonged bleeding was recorded in 17/46 evaluable participants (37.0%). Menstrual-related healthcare use or absence was more frequent among those with documented bleeding than among those without it (9/17 vs 4/29; Fisher P = 0.007). The proportion with documented bleeding varied across seven observed regimens (P=0.006) and was highest among rivaroxaban recipients (13/19, 68.4%). Conclusions: Menstrual changes and bleeding-related clinical burden were observed during follow-up in women receiving antithrombotic therapy for cardiovascular conditions. The proportion with documented bleeding varied across observed regimens and was highest among rivaroxaban recipients. Larger prospective studies using standardized menstrual outcome measures are needed to evaluate between-regimen differences.
No takes yet. Share an insight, caveat, or question.
Shen et al. (2026) conducted an observational in Cardiovascular conditions requiring antithrombotic therapy (n=50). Cardiovascular antithrombotic therapy (anticoagulant and antiplatelet regimens) vs. Baseline pre-treatment menstrual status (paired design) was evaluated on Paired changes in abnormal menstrual-cycle category and prolonged menstrual duration (p=0.031). Cardiovascular antithrombotic therapy was associated with increased abnormal menstrual cycles (28.0% vs 16.0%) and prolonged menses (16.3% vs 4.1%; both P=0.031).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: