The following is a summary of “Abnormal uterine bleeding patterns determined through menstrual tracking among participants in the Apple Women’s Health Study,” published in the FEBRUARY 2023 issue of Obstetrics and Gynecology by Zhang, et al.

Due to the absence of important demographic and health information as well as validation of menstrual tracking accuracy, the use of menstrual tracking data to comprehend aberrant bleeding patterns has been restricted. For a study, researchers sought to discover abnormal uterine bleeding patterns, as well as their prevalence, and to confirm previous and anticipated correlations between abnormal uterine bleeding patterns, societal characteristics, and health issues.

The investigation included participants from the Apple Women’s Health Study who provided menstruation tracking data from November 2019 through July 2021 but did not indicate pregnancy, lactation, hormone usage, or menopause. Unusual menses, rare menses, protracted menses, and irregular intermenstrual bleeding were all examined as four atypical uterine bleeding patterns (spotting). Inaccurate or incomplete digital records were excluded using monthly monitoring confirmation based on survey responses. They looked at the demographic factors that influence the prevalence of abnormal uterine bleeding and utilized logistic regression to assess the correlation between abnormal uterine bleeding and a number of self-reported medical disorders.

With a mean age of 33 (standard deviation: 8.2) years, a mean body mass index of 29.3 (standard deviation: 8.0), and identification as White, non-Hispanic at 68.9% (95% CI: 68.2-69.5), there were 18,875 participants who matched the inclusion criteria. After accurate tracking was confirmed, 16.4% of participants had abnormal uterine bleeding (n=3,103; 95% CI, 15.9-17.0); 2.9% had irregular menses (95% CI, 2.7-3.1); 8.4% had infrequent menses (95% CI, 8.0-8.8); 2.3% had prolonged menses (95% CI, 2.1-2.5); and 6.1% had spotting (95% CI, 5.7-6.4). After adjusting for age and body mass index, Black participants had a 33% higher prevalence of infrequent menses (prevalence ratio, 1.33; 95% CI, 1.09-1.61) than White, non-Hispanic participants. After adjusting for age and race/ethnicity, it was found that class 1, class 2, and class 3 obesity all had higher rates of infrequent menstruation (class 1: body mass index, 30–34.9; prevalence ratio, 1.31; 95% CI, 1.13–1.52; class 2: body mass index, 35–39.9; prevalence ratio, 1.25; 95% CI, 1.05–1.49; class 3: body mass index, >40; prevalence ratio, 1.51; 95% CI, 1.21–1.88). In comparison to people who were healthy weight, those with class 3 obesity showed an 18% greater prevalence of abnormal uterine bleeding (prevalence ratio, 1.18; 95% CI, 1.02-1.38). Comparing people with and without the polycystic ovarian syndrome, abnormal uterine bleeding was more common in the former by 19% (prevalence ratio, 1.19; 95% CI, 1.08-1.31). The prevalence of abnormal uterine bleeding was higher in participants with hyperthyroidism (prevalence ratio, 1.34; 95% CI, 1.13-1.59) and hypothyroidism (1.17; 95% CI, 1.05-1.31) as well as endometriosis (prevalence ratio, 1.28; 95% CI, 1.12-1.45), cervical dysplasia (prevalence ratio, 1.20; 95% CI, 1.03-1.39), and fibroids (prevalence ratio, 1.14; 95% CI, 1.00–1.30)

16.4% of the participants in the cohort who had confirmed menstruation monitoring had abnormal uterine bleeding. The prevalence of abnormal uterine hemorrhage was higher in persons who were obese or of color. There was a higher prevalence of abnormal uterine bleeding among participants who had diseases such as polycystic ovarian syndrome, thyroid disease, endometriosis, and cervical dysplasia.

Reference: ajog.org/article/S0002-9378(22)00839-0/fulltext