DAME study: Dabigatran versus apixaban effect on heavy menstrual bleeding (HMB) evaluation in women of childbearing age

Heavy menstrual bleeding (HMB) in women of childbearing age on anticoagulation is likely under-reported, but is a significant issue. Studies to date suggest that oral factor Xa inhibitors may be associated with a higher risk of HMB than direct thrombin inhibitors, and that dabigatran is likely to be associated with less HMB than apixaban, however more data is required to confirm this. If a particular class of anticoagulant can be demonstrated to have a lower incidence of HMB, then this could be useful to guide clinicians as to which anticoagulant to use in women of childbearing age requiring anticoagulation, particularly those who have pre-existing issues with HMB. We aim to prospectively collect data on women of childbearing age on anticoagulation for VTE (venous thromboembolism), recording their menstrual bleeding both at baseline and after six months of anticoagulation. We will compare HMB rates on dabigatran and apixaban. The data on apixaban will be collected mainly from our collaborating centre/s in the UK and Australia, as apixaban is not funded for VTE in NZ.