New research highlights a significant connection between abnormal uterine bleeding (AUB) and heightened fatigue among women undergoing the menopause transition. The study, published in Menopause, the journal of The Menopause Society, reveals that prolonged or heavy menstrual bleeding may significantly contribute to syndromic fatigue, a condition two to four times more common in midlife women. This finding underscores the importance of addressing AUB as part of comprehensive healthcare for women experiencing menopause.

The Study of Women’s Health Across the Nation (SWAN) has shown that approximately one-third of women transitioning through menopause experience episodes of AUB, characterized by changes in menstrual flow. Despite its prevalence, limited attention has been given to this issue, both in medical research and public discourse. This large-scale study analyzed daily menstrual calendar data from over 2,300 women to investigate whether prolonged or heavy menstrual bleeding during the six months preceding a follow-up visit was linked to specific symptoms of fatigue, such as feeling worn out, lacking energy, or not feeling full of pep. The results indicate a clear association between AUB and an increased risk of fatigue, even when adjusting for other potential causes.

Heavy menstrual bleeding, in particular, can lead to iron deficiency anemia, a well-known cause of fatigue. The researchers emphasize the need for greater clinical awareness of bleeding changes during the menopause transition, especially when fatigue is also reported. Early assessment and treatment of these symptoms could greatly improve the quality of life for many women. Dr. Stephanie Faubion, medical director of The Menopause Society, stresses the importance of educating women about the possibility of AUB during menopause and its potential health consequences.

This research underscores the necessity for healthcare providers to be more vigilant in recognizing and addressing AUB in midlife women. By raising awareness and promoting early intervention, clinicians can help mitigate the impact of AUB on women's overall well-being. The findings also highlight the need for further education and resources to support women navigating the challenges of menopause.