{"paper_id":"862b4436-b489-464f-8404-2972a55d985b","body_text":"The relation of heavy or prolonged bleeding during the menopause transition to risk of hysterectomy\nAbstract\nBackground:\nObjectives:\nDesign:\nMethods:\nResults:\nConclusion:\nPlain language summary\nIntroduction\nMethods\nAbnormal uterine bleeding\nMenopause\nCovariates\nStatistical analysis\nResults\n| Variables | N (%) | Hysterectomy | p valuea | |\n|---|---|---|---|---|\n| No (N = 1125), N (%) | Yes (N = 75), N (%) | |||\n| Bleeding >8 days at least three times within 6 months (PMB) | 358 (29.83) | 325 (28.89) | 33 (44.00) | 0.006 |\n| Heavy bleeding ⩾3 days at least three times within 6 months (HMB) | 208 (17.33) | 186 (16.53) | 22 (29.33) | 0.005 |\n| Pelvic pain | 359 (29.92) | 319 (28.36) | 40 (53.33) | <0.001 |\n| Hormone therapy use | 380 (31.67) | 335 (29.78) | 45 (60.00) | <0.001 |\n| Any type of bleeding interference | 786 (65.50) | 730 (64.89) | 56 (74.67) | 0.085 |\n| Total types of interference reported due to bleeding | <0.001 | |||\n| 0 | 414 (34.50) | 395 (35.11) | 19 (25.33) | |\n| 1 | 254 (21.17) | 239 (21.24) | 15 (20.00) | |\n| 2 | 179 (14.92) | 172 (15.29) | 7 (9.33) | |\n| 3 | 151 (12.58) | 144 (12.80) | 7 (9.33) | |\n| 4 | 202 (16.83) | 175 (15.56) | 27 (36.00) | |\n| Race/ethnicity | 0.062 | |||\n| Black | 185 (15.42) | 166 (14.76) | 19 (25.33) | |\n| White | 545 (45.42) | 511 (45.42) | 34 (45.33) | |\n| Chinese | 221 (18.42) | 212 (18.84) | 9 (12.00) | |\n| Japanese | 249 (20.75) | 236 (20.98) | 13 (17.33) | |\n| Education | 0.939 | |||\n| Less than high school | 55 (4.58) | 51 (4.53) | 4 (5.33) | |\n| High school | 186 (15.50) | 174 (15.47) | 12 (16.00) | |\n| Greater than high school | 959 (79.92) | 900 (80.00) | 59 (78.67) | |\n| How hard to pay for basics | 0.513 | |||\n| Very | 77 (6.42) | 73 (6.49) | 4 (5.33) | |\n| Somewhat | 302 (25.17) | 279 (24.80) | 23 (30.67) | |\n| Not at all | 821 (68.42) | 773 (68.71) | 48 (64.00) | |\n| Current smoker | 292 (24.33) | 272 (24.18) | 20 (26.67) | 0.728 |\n| Obeseb | 390 (32.50) | 363 (32.27) | 27 (36.00) | 0.589 |\n| Variables | Unadjusted models | Adjusteda model without life interference | Adjusted model with life interference | |||\n|---|---|---|---|---|---|---|\n| HR (95% CI) | p value | HR (95% CI) | p value | HR (95% CI) | p value | |\n| PMB models | ||||||\n| PMB | 2.75 (1.41–5.37) | 0.003 | 2.35 (1.20–4.61) | 0.013 | 1.72 (0.87–3.43) | 0.121 |\n| Pelvic pain | 2.63 (1.55–4.48) | <0.001 | 1.98 (1.15–3.42) | 0.014 | 1.80 (1.04–3.10) | 0.034 |\n| Hormone use | 3.16 (1.92–5.19) | <0.001 | 2.97 (1.79–4.92) | <0.001 | 2.49 (1.50–4.16) | <0.001 |\n| Black womenb | 2.17 (1.29–3.66) | 0.004 | 2.28 (1.34–3.88) | 0.003 | 1.82 (1.06–3.12) | 0.030 |\n| Number of types of interference | 1.73 (1.48–2.02) | <0.001 | - | - | 1.52 (1.29–1.79) | <0.001 |\n| Educationc | ||||||\n| Less than high school | 1.45 (0.53–4.01) | 0.470 | – | – | – | – |\n| High school | 1.13 (0.61–2.10) | 0.704 | – | – | – | – |\n| How hard to pay for very basicsd | ||||||\n| Very | 0.93 (0.33–2.58) | 0.886 | – | – | – | – |\n| Somewhat | 1.36 (0.83–2.24) | 0.222 | – | – | – | – |\n| Current smokere | 1.26 (0.74–2.14) | 0.402 | – | – | – | – |\n| Obesef | 1.18 (0.72–1.94) | 0.500 | – | – | – | – |\n| HMB models | ||||||\n| HMB | 1.72 (0.54–5.51) | 0.358 | 1.34 (0.42–4.30) | 0.623 | 0.88 (0.27–2.86) | 0.834 |\n| Pelvic pain | – | 2.03 (1.18–3.50) | 0.011 | 1.81 (1.05–3.12) | 0.032 | |\n| Hormone use | – | 3.09 (1.87–5.10) | <0.001 | 2.57 (1.54–4.27) | <0.001 | |\n| Black women | – | 2.19 (1.29–3.73) | 0.004 | 1.76 (1.03–3.02) | 0.039 | |\n| Number of types of interference | – | – | – | 1.56 (1.32–1.83) | <0.001 |\nDiscussion\nLimitation\nAcknowledgments\nEthical considerations\nDeclaration of conflicting interests\nFunding\nORCID iDs\nData availability statement\nReferences\nSupplementary Material\nPlease find the following supplemental material available below.\nFor Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.\nFor non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.\nCite\nCite\nCite\nDownload to reference manager\nIf you have citation software installed, you can download citation data to the citation manager of your choice\nInformation, rights and permissions\nInformation\nPublished In\nKeywords\nData availability statement\nArticle versions\nAuthors\nAuthor contributions\nMetrics and citations\nMetrics\nPublication usage*\nTotal views and downloads: 727\n*Publication usage tracking started in December 2016\nPublications citing this one\nReceive email alerts when this publication is cited\nWeb of Science: 0\nCrossref:\nThere are no citing articles to show.\nFigures and tables\nFigures & Media\nTables\nView Options\nView options\nPDF/EPUB\nView PDF/EPUBAccess options\nIf you have access to journal content via a personal subscription, university, library, employer or society, select from the options below:\nloading institutional access options\nAlternatively, view purchase options below:\nPurchase 24 hour online access to view and download content.\nAccess journal content via a DeepDyve subscription or find out more about this option.","source_license":"CC0","license_restricted":false}