{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T14:29:31Z","timestamp":1793456971168,"version":"4.5.0"},"reference-count":23,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2014,6,9]],"date-time":"2014-06-09T00:00:00Z","timestamp":1402272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Research Fund of Hospital District Helsinki and Uusimaa","award":["M60895PEV12"],"award-info":[{"award-number":["M60895PEV12"]}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2014,7]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n \n To assess the impact of anemia and iron deficiency on health\u2010related quality of life (HRQoL) in women treated for heavy menstrual bleeding (\n HMB<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Secondary analysis of a randomized controlled trial.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Five university hospitals in Finland.<\/jats:p>\n <\/jats:sec>\n \n Sample<\/jats:title>\n \n A total of 236 women referred for\n HMB<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Women were randomized to treatment with hysterectomy or a levonorgestrel\u2010releasing intrauterine system. We defined groups based on women's pretreatment hemoglobin [hemoglobin <120\u00a0g\/L (anemic) vs. hemoglobin \u2265120\u00a0g\/L (nonanemic)] and serum ferritin (ferritin <15\u00a0\u03bcg\/L vs. \u226515\u00a0\u03bcg\/L) concentrations.\n HRQ<\/jats:styled-content>\n oL was compared between groups at baseline, 6 and 12\u00a0months after treatment. Hemoglobin and ferritin were followed for 5\u00a0years.\n <\/jats:p>\n <\/jats:sec>\n \n Main outcome measures<\/jats:title>\n \n HRQ<\/jats:styled-content>\n oL was measured by the\n RAND<\/jats:styled-content>\n 36\u2010item health survey (\n RAND<\/jats:styled-content>\n \u201036), 5\u2010Dimensional EuroQol and two questionnaires of mental wellbeing.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n At baseline, 63 women (27%) were anemic and 140 (60%) were severely iron deficient (ferritin <15\u00a0\u03bcg\/L). Only 8% of the anemic women had taken iron supplementation. Twelve months after treatment hemoglobin had increased in both hemoglobin groups, but was still significantly lower (\n p\u00a0<\/jats:italic>\n <\u00a00.001) in initially anemic women (128\u00a0g\/L) compared with nonanemic women (136\u00a0g\/L). Twelve months after treatment three domain scores of\n RAND<\/jats:styled-content>\n \u201036 increased more (energy,\n p\u00a0<\/jats:italic>\n =\u00a00.002; physical functioning,\n p\u00a0<\/jats:italic>\n =\u00a00.04; social functioning,\n p\u00a0<\/jats:italic>\n =\u00a00.05), and anxiety (\n p\u00a0<\/jats:italic>\n =\u00a00.02) and depression scores (\n p\u00a0<\/jats:italic>\n =\u00a00.002) decreased more in anemic compared with nonanemic women. Serum ferritin took 5\u00a0years to reach normal levels.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Improved\n HRQ<\/jats:styled-content>\n oL after treatment of\n HMB<\/jats:styled-content>\n is associated with correction of anemia. Clinicians should actively screen for anemia in women with\n HMB<\/jats:styled-content>\n and emphasize early iron substitution as an integral part of treatment.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/aogs.12394","type":"journal-article","created":{"date-parts":[[2014,6,9]],"date-time":"2014-06-09T20:48:40Z","timestamp":1402346920000},"page":"654-660","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":101,"title":["Effects of anemia and iron deficiency on quality of life in women with heavy menstrual bleeding"],"prefix":"10.1111","volume":"93","author":[{"given":"Pirkko","family":"Peuranp\u00e4\u00e4","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Hyvink\u00e4\u00e4 Hospital Hospital District of Helsinki and Uusimaa Hyvink\u00e4\u00e4 Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satu","family":"Heli\u00f6vaara\u2010Peippo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hyvink\u00e4\u00e4 Hospital Hospital District of Helsinki and Uusimaa Hyvink\u00e4\u00e4 Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Fraser","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Neonatology The Queen Elizabeth II Research Institute for Mothers and Infants University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorma","family":"Paavonen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Helsinki University Central Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritva","family":"Hurskainen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hyvink\u00e4\u00e4 Hospital Hospital District of Helsinki and Uusimaa Hyvink\u00e4\u00e4 Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,6,9]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"359","article-title":"An epidemiological survey of symptoms of menstrual loss in the community","volume":"54","author":"Shapley M","year":"2004","journal-title":"Br J Gen 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