The Impact of Heavy Menstrual Bleeding on Quality of Life: A Mixed-Methods Survey Study

To examine the physical, psychological, social, and functional impact of heavy menstrual bleeding (HMB) using a mixed-methods approach.

Mixed-methods online survey.

A UK-wide sample of adults assigned female at birth with lived experience of HMB. Participants were recruited between June and July 2024 via social media, menstrual-health charities and the Katie's Team and Co-Production Collective networks.

Participants completed an online questionnaire comprising multiple-choice and open-ended items. Qualitative data were analysed inductively using thematic analysis and quantitative data were summarised descriptively. Findings were integrated to understand the multi-dimensional impact of HMB. Patient and public involvement informed survey development.

Menstrual cycle characteristics; self-reported physical, psychological, social, and functional impacts of HMB.

105 participants were included. Most reported bleeding lasting ≥ 6 days and long-standing HMB beginning early in their reproductive lives. Severe or very severe impact was reported across physical health (83%), mental health (73%), social participation (83%), and sexual relationships (59%). Qualitative findings highlighted profound fatigue, symptoms consistent with anaemia, pain, cognitive difficulties, and night-time disruption. Participants described pervasive anxiety regarding leakage, altered career or study trajectories, and adverse effects on intimacy and relationships. Many structured daily routines around access to toilets and sanitary protection. Experiences of stigma and unmet healthcare needs were common.

Among participants, HMB was associated with quality of life impairment across multiple domains, extending far beyond bleeding volume. These findings underscore the importance of holistic, patient-centred management, including timely investigation, appropriate medical therapy, and psychosocial support.