About one in four women of reproductive age experience uncomfortable and painful heavy menstrual bleeding. For some women, the pain and dizziness from rapid and excessive blood loss requires emergency treatment. The true incidence of acute heavy menstrual bleeding is not known due to limited data. Researchers in the United Kingdom retrospectively reviewed data from 98 of 182 (54%) National Health Service gynecology units in teaching hospitals, focusing on women admitted with acute heavy menstrual bleeding who received at least one RBC transfusion. In the first half of 2024, 1332 women of reproductive age (61% older than 40 years; 38% White; 49% with uterine fibroids) were admitted and transfused a total of 3025 units of RBCs to treat heavy menstrual bleeding (2.2 units per admission). No association, however, was found between pre-transfusion hemoglobin levels and the number of units transfused nor the post-transfusion hemoglobin. Other common inpatient treatments included tranexamic acid (62%), oral hormonal therapy (51%), and ferrous sulphate (53%). The mean cost of admission for acute heavy menstrual bleeding was £2972 per admission. In addition to advancing the understanding of the pathophysiology of acute heavy bleeding and best treatment options, further research is needed to characterize the incidence of acute heavy bleeding as only women who received RBC transfusions were included in this study.
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