{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T02:54:18Z","timestamp":1787799258852,"version":"build-2784847793"},"reference-count":16,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T00:00:00Z","timestamp":1752451200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T00:00:00Z","timestamp":1752451200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Appl Thromb Hemost"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Women with von Willebrand Disease (VWD) frequently experience heavy menstrual bleeding (HMB), impacting their health and quality of life. Hormonal contraceptives are a standard treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>We hypothesized that women with type 1 VWD using hormonal therapy would have lower bleeding scores and potentially higher VWF levels than non-users. To test this, we compared demographics, VWF levels, and International Society on Thrombosis and Haemostasis Bleeding Assessment Tool (ISTH-BAT) scores between hormone users and non-users in the Zimmerman Program cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from 269 women with type 1 VWD enrolled in the Zimmerman Program were analyzed. Of these, 103 were hormone users, including oral contraceptives (71), medroxyprogesterone acetate (11), levonorgestrel IUD (11), contraceptive implant (3), and the etonogestrel\/ethinyl estradiol vaginal ring (1) and (6) subjects were undergoing hormone replacement therapy. Participants who were postmenopausal were excluded from the study results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>HMB was reported by 252 out of 269 participants (94%), with 118 (47%) reporting severe symptoms. While hormone users were younger than non-users, 22.3 versus 23.2 years, (p\u2009=\u2009.003), VWF levels were similar between groups, (0.36 vs 0.38IU\/mL). Age-adjusted BAT scores revealed that in all age groups, more than 70% of patients had abnormal bleeding scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hormonal therapy users had lower total BAT scores compared to non-users, though differences were not statistically significant. These findings suggest a potential but limited effect of hormone use on bleeding phenotype in women with type 1 VWD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10760296251359294","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T06:53:00Z","timestamp":1752562380000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Heavy Menstrual Bleeding and Hormonal Therapy in Women with Type 1 von Willebrand Disease Enrolled on the Zimmerman Program"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2776-8987","authenticated-orcid":false,"given":"Nicoletta","family":"Machin","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Classical Hematology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA"},{"name":"Hemophilia Center of Western PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Navarrete","sequence":"additional","affiliation":[{"name":"Universidad Francisco Marroquin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Rothenberger","sequence":"additional","affiliation":[{"name":"University of Pittsburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8998-6838","authenticated-orcid":false,"given":"Veronica","family":"Flood","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Medical College of Wisconsin"},{"name":"Versiti Blood Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6758-9815","authenticated-orcid":false,"given":"Pamela","family":"Christopherson","sequence":"additional","affiliation":[{"name":"Versiti Blood Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Montgomery","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Medical College of Wisconsin"},{"name":"Versiti Blood Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7830-5379","authenticated-orcid":false,"given":"Margaret V","family":"Ragni","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Classical Hematology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA"},{"name":"Hemophilia Center of Western PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Zimmerman Program Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,14]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2020.07.051"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020003264"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2021005589"},{"issue":"2","key":"e_1_3_3_5_2","article-title":"Interventions for heavy menstrual bleeding; overview of Cochrane reviews and network meta-analysis","volume":"2023","author":"Bofill Rodriguez M","year":"2022","unstructured":"Bofill Rodriguez M, Dias S, Jordan V, et al. Interventions for heavy menstrual bleeding; overview of Cochrane reviews and network meta-analysis. Cochrane Database Syst Rev. 2022;2023(2):CD013180. doi:https:\/\/doi.org\/10.1002\/14651858.cd013180.pub2","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.3892\/etm.2016.3144"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2023.01.017"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2020.05.008"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbrc.2021.04.019"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1182\/hematology.2022000389"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-10-673681"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtha.2022.11.045"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1160\/TH12-04-0244"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2016.1.236"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(23)00119-9"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2023011742"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2023-180498"}],"container-title":["Clinical and Applied Thrombosis\/Hemostasis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10760296251359294","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10760296251359294","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10760296251359294","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:05:17Z","timestamp":1777385117000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10760296251359294"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,14]]},"references-count":16,"alternative-id":["10.1177\/10760296251359294"],"URL":"https:\/\/doi.org\/10.1177\/10760296251359294","relation":{},"ISSN":["1076-0296","1938-2723"],"issn-type":[{"value":"1076-0296","type":"print"},{"value":"1938-2723","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,14]]},"article-number":"10760296251359294"}}