New study to help improve issue that affects up to one in three women

Pioneering imaging and wearable technology are being used to improve care for women with heavy menstrual bleeding (HMB).

The new research project, led in Southampton, aims to develop the first physiology-informed diagnostic tool for HMB. This could give women faster access to care and better options.

HMB is a symptom where periods are unusually heavy, but scientists still don’t fully understand why it happens. This makes it hard to diagnose and treat properly.

Researchers in Southampton and New Zealand are working together on a new approach to tackle the issue.

The REPAIR project is led by Professor Ying Cheong from the University of Southampton and University Hospital Southampton.

Leading change

HMB often involves blood loss so significant that if it was associated with an injury, it would result in a call for an ambulance or a trip to the emergency room.

Reported by up to one in three women, it is more common than asthma or diabetes in reproductive-aged women. It is a major contributor to iron deficiency. If left untreated, this can progress to anaemia, which at its most severe requires a blood transfusion.

Yet it currently takes an average of five years to get effective treatment for HMB. This is partly because the mechanisms behind it remain elusive, despite decades of research.

The REPAIR project's study will be part of The Missed Vital Sign programme. This is a $50 million women's health initiative led by Wellcome Leap, a US-based nonprofit focused on accelerating breakthroughs in human health. Bringing together researchers from across the world, the goal of the programme is to reduce the time it takes a woman to get effective treatment for HMB more than tenfold.

State-of-the-art technology

It is difficult to accurately identify those with HMB, which confuses results from research. To fix this, the REPAIR project is taking a new approach.

Instead of relying only on symptoms, researchers will use advanced tools to study the uterus’s structure, biology, and function.

They will use wearable uterine electrophysiology. This uses electrodes on the skin of a woman’s belly to detect electrical signals from muscle activity in the womb.

They will combine this with data from MRI imaging and tissue samples taken from the lining of the womb.

Through this new knowledge, researchers aim to move toward accurate, non-invasive confirmation of HMB and personalised treatments.

REPAIR will bring together a team of clinicians, engineers, biologists and data scientists.

A leap forward

The project’s full title is Reframing Endometrial Physiology by Advanced Integrated Research (REPAIR).

Professor Cheong is a Professor of Reproductive Medicine at the University of Southampton. She is an Honorary Consultant at University Hospital Southampton.

She will lead REPAIR with three Co-Principal Investigators. These are Professor Rohan Lewis in Southampton, and Professors Leo Cheng and Alys Clark from the University of Auckland.

Professor Cheong said: "Our aim is to reduce the years of uncertainty experienced by many women, and to lay the foundations for diagnostic tests that are accurate, accessible, and grounded in real physiology. If we succeed, we won’t just improve care for women with heavy bleeding, we’ll change how the field understands the uterus altogether."

The study is recruiting volunteers aged between 18 and 45. They will have normal or heavy periods and must not be on any hormonal treatment. Participants are reimbursed £150 for each visit to University Hospital Southampton.

For further information or to take part, please contact claire.holton@uhs.nhs.uk.