Evidence map›Paper›PMID 40534379›Full record

SynthesisHaemophilia : the official journal of the World Federation of Hemophilia2025

Clotting Factor Concentration During Menstrual Phases in Women With and Without Heavy Menstrual Bleeding: A Systematic Review and Meta-Analysis.

Anne de Vaan, Merel M Goedkoop, Paco M J Welsing, Nehalennia van Hanegem, Roger E G Schutgens, Karin P M van Galen

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Haemophilia : the official journal of the World Federation of Hemophilia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Sex Differences in Cancer-Associated Thrombosis.International journal of molecular sciences · 2026
    Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Anne de VaanCenter for Benign Hematology, Thrombosis and Hemostasis, van Creveldkliniek, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.ORCID https://orcid.org/0000-0001-6980-0477
Merel M GoedkoopCenter for Benign Hematology, Thrombosis and Hemostasis, van Creveldkliniek, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Paco M J WelsingDepartment of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Nehalennia van HanegemDepartment of Reproductive Medicine & Gynaecology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Roger E G SchutgensCenter for Benign Hematology, Thrombosis and Hemostasis, van Creveldkliniek, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.ORCID https://orcid.org/0000-0002-2762-6033
Karin P M van GalenCenter for Benign Hematology, Thrombosis and Hemostasis, van Creveldkliniek, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.ORCID https://orcid.org/0000-0003-3251-8595

Funding

Octapharma
6 · The paper itself

Abstract

backgroundCyclic sex-hormone fluctuation impacts clotting factor concentrations, being lowest during the follicular phase of the menstrual cycle. This pattern is unexplored in women with heavy menstrual bleeding (HMB), but potentially affects the timely diagnosis of underlying bleeding disorders.

aimComparing clotting factor fluctuation in the follicular versus luteal phase, between women with and without HMB.

methodsA PubMed/MEDLINE systematic review on HMB and clotting factors. Articles reporting clotting factor concentrations in premenopausal women with and without HMB were included, categorized by follicular or luteal phase if the sampling moment was specified. A meta-analysis was performed and the effect of HMB on (cyclic) clotting factor concentrations was assessed.

resultsA total of 21 out of 2158 articles were included. Clotting factors II, V, VII-XI, fibrinogen and von Willebrand factor (VWF) during the follicular and luteal phases were reported in women with HMB. All measurements in women with HMB were performed during the follicular or unspecified phase, hindering phase-specific assessment. Irrespective of phase, pooled measurements in women with HMB suggested elevated FVIII (pooled difference 21.8 IU/dL, 95% CI: 4.5-39.1, p = 0.01) and FV concentrations (pooled difference 15.8 IU/dL, 95% CI: 6.0-25.5, p = 0.002), but not VWF activity (pooled difference -11.0 IU/dL, 95% CI: -27.9 to 5.9, p = 0.20), compared to women without HMB.

conclusionBased on meta-analysis of limited data, women with HMB tend to exhibit slightly higher FVIII and FV concentrations as compared to those without. More research is needed in the follicular phase of women with HMB to assess the effect of menstrual phases on HMB.

Indexed as

Blood Coagulation FactorsMenorrhagiaMenstrual CycleFemaleFollicular PhaseHumansLuteal PhaseBlood Coagulation Factorsblood coagulation disordersblood coagulation factorsmenorrhagiamenstruationvon willebrand disease

Identifiers

PMID40534379
PMCPMC12311891

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.