{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:52:32Z","timestamp":1792785152419,"version":"4.5.0"},"reference-count":29,"publisher":"Georg Thieme Verlag KG","issue":"06","funder":[{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100018693","name":"HORIZON EUROPE Framework Programme","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100018693","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100019186","name":"HORIZON EUROPE Innovative Europe","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100019186","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100018703","name":"HORIZON EUROPE European Innovation Council","doi-asserted-by":"crossref","award":["Grant Agreement No. 101137227"],"award-info":[{"award-number":["Grant Agreement No. 101137227"]}],"id":[{"id":"10.13039\/100018703","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Ricerca Corrente"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Oral anticoagulants (OAC) may exacerbate menstrual bleeding in women of childbearing age; however, the existing literature on this issue has several limitations.<\/jats:p>\n                  <jats:p>This study investigates abnormal uterine bleeding in women of childbearing age taking OAC\u2013vitamin K antagonists or direct oral anticoagulants\u2013for venous thromboembolism through a retrospective analysis of prospectively collected data. Uterine bleeding was assessed using the Pictorial Blood Assessment Chart (PBAC) and hemoglobin (Hb) values during anticoagulation compared with prior therapy. The number of unplanned medical visits for bleeding complications was also calculated.<\/jats:p>\n                  <jats:p>From June 2014 to November 2023, 110 women were recruited (median age, 36 years). PBAC scores correlated with Hb values at baseline and during therapy (analysis of variance [ANOVA], p\u2009&lt;\u20090.01), with a significant difference in Hb values before and during anticoagulant therapy (delta Hb) among groups (ANOVA, p.0.034). Seventeen women (15.5%) reported uterine fibroids, experiencing a greater reduction in Hb values during anticoagulant administration than women without uterine fibroids (delta 0.3, interquartile range [IQR]: 0.8, 2.9 vs. 0.5, IQR 1.2, 0.3; p.0.012). Women with selfreported uterine fibroids required more frequent unplanned medical consultations for bleeding (mean visits 5 vs. 4, respectively; Poisson regression, p\u2009&lt;\u20090.05). Among women with uterine fibroids, those taking apixaban showed smaller Hb changes than those on other oral anticoagulants (ANOVA, p.0.047). This difference persisted even after adjusting for potential confounders (multiple ANOVA, p.0.004).<\/jats:p>\n                  <jats:p>Women of childbearing age taking OAC frequently experience changes in Hb values and PBAC scores during treatment, with uterine fibroids playing a significant role.<\/jats:p>","DOI":"10.1055\/a-2461-6822","type":"journal-article","created":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T19:03:52Z","timestamp":1730919832000},"page":"523-532","source":"Crossref","is-referenced-by-count":7,"title":["Blood Loss in Women of Childbearing Potential Taking Oral Anticoagulants for Venous Thromboembolism (The BLEED Study)"],"prefix":"10.1055","volume":"125","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8980-9783","authenticated-orcid":false,"given":"Elvira","family":"Grandone","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Department, University of Foggia, Foggia, Italy"},{"name":"Thrombosis and Haemostasis Unit, Fondazione I.R.C.C.S. \u201cCasa Sollievo della Sofferenza\u201d, S. Giovanni R., Foggia, Italy"},{"name":"Department of Obstetrics, Gynaecology and Perinatal Medicine, The First I.M. Sechenov Moscow State Medical University, Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Mastroianno","sequence":"additional","affiliation":[{"name":"Scientific Direction, Fondazione I.R.C.C.S. \u201cCasa Sollievo della Sofferenza\u201d, S. Giovanni R., Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Pacilli","sequence":"additional","affiliation":[{"name":"Thrombosis and Haemostasis Unit, Fondazione I.R.C.C.S. \u201cCasa Sollievo della Sofferenza\u201d, S. Giovanni R., Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donatella","family":"Colaizzo","sequence":"additional","affiliation":[{"name":"Thrombosis and Haemostasis Unit, Fondazione I.R.C.C.S. \u201cCasa Sollievo della Sofferenza\u201d, S. Giovanni R., Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Margaglione","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Foggia, Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Behnood","family":"Bikdeli","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine and Thrombosis Research Group, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States"},{"name":"Yale New Haven Hospital\/Yale Center for Outcomes Research and Evaluation, New Haven, Connecticut, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Piazza","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine and Thrombosis Research Group, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,11,21]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1182\/hematology.2020000138","article-title":"Management of heavy menstrual bleeding on anticoagulation","volume":"2020","author":"B Samuelson Bannow","year":"2020","journal-title":"Hematology (Am Soc Hematol Educ Program)"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.contraception.2010.12.011","article-title":"Menstrual problems and contraception in women of reproductive age receiving oral anticoagulation","volume":"84","author":"F Y Huq","year":"2011","journal-title":"Contraception"},{"key":"ref3","first-page":"89","article-title":"The risk of menstrual bleeding among new users of anticoagulants: a systematic review","volume":"158","author":"R Godin","year":"2017","journal-title":"Thromb Res"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"100072","DOI":"10.1016\/j.rpth.2023.100072","article-title":"How do anticoagulants impact menstrual bleeding and quality of life? - The PERIOD study","volume":"7","author":"J P Patel","year":"2023","journal-title":"Res Pract Thromb Haemost"},{"issue":"S 02","key":"ref5","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1002\/ijgo.14946","article-title":"Contemporary evaluation of women and girls with abnormal uterine bleeding: FIGO Systems 1 and 2","volume":"162","author":"V Jain","year":"2023","journal-title":"Int J Gynaecol Obstet"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1016\/j.thromres.2015.07.030","article-title":"Abnormal uterine bleeding in VTE patients treated with rivaroxaban compared to vitamin K antagonists","volume":"136","author":"N De Crem","year":"2015","journal-title":"Thromb 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Gynecol"},{"issue":"14","key":"ref28","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1093\/eurheartj\/ehac776","article-title":"Recurrent venous thromboembolism and bleeding with extended anticoagulation: the VTE-PREDICT risk score","volume":"44","author":"M A de Winter","year":"2023","journal-title":"Eur Heart J"},{"issue":"14","key":"ref29","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1093\/eurheartj\/ehac731","article-title":"Walking the tightrope: a balanced discussion of the benefits and harms of extended duration anticoagulation for venous thrombo-embolism","volume":"44","author":"G Piazza","year":"2023","journal-title":"Eur Heart J"}],"container-title":["Thrombosis and 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