Reproductive
The effect of daily low dose aspirin use on bleeding patterns. Ibironke A. Ajayi* Ibironke Ajayi Maegan E. Boutot Brian W. Whitcomb
Background: The menstrual cycle has been described as a “vital sign” of women’s reproductive health and wellbeing. Abnormal bleeding patterns may indicate reproductive abnormalities or other conditions. Low dose aspirin(LDA) is widely used for disease prevention but increases risk of bleeding. There is limited data evaluating the impact of aspirin on menstrual bleeding and its role as a “vital sign” to provide an evidence-basis for clinical recommendations.
Methods: The Effects of Aspirin in Gestation and Reproduction (EAGeR) trial randomly assigned women aged 18-40 years with history of one or two pregnancy losses to LDA treatment (daily 81mg/day aspirin plus daily 400-mcg folic acid) or placebo (daily 400-mcg folic acid). Daily LDA(81mg). For this analysis, two outcomes were compared by treatment assignment: period bleed days (number of menses bleeding days of any intensity allowing no more than 1 bleed free day to define a consecutive bleeding segment) and total menstrual cycle days of bleeding (including bleeding of any intensity and at any time within the menstrual cycle) from the 2nd cycle (defined as the longest string of bleeding of any intensity between days 20 and 50) of follow up, used for completeness of data recorded by participants in daily diaries.
Results: LDA was associated with minor, non-significant higher period bleed days (p= 0.23). Average total bleeding days among the LDA groups (8.2days, 95%CI= 7.9,8.6) were non significantly higher than that in the placebo group (7.8days, 95%CI= 7.4,8.3).
Conclusion: The results do not indicate a significant effect of daily LDA on menstrual cycle bleeding that would compromise the use of bleeding patterns as a “biomarker”. Due to the modest sample size, limited participant diversity (95% of total participants were white), and the overall healthy study population, further research is necessary to confirm these findings and assess their generalizability across broader populations.
