It affects up to one-third of the human population and can create symptoms severe enough to lead to hospitalization, yet much about what causes it remains a mystery. It’s rarely discussed in public, often goes undiagnosed, and remains a consistently underfunded and understudied area of science.  

What is this mystery condition? Heavy menstrual bleeding (HMB), which can cause severe pain, anemia, fatigue, and may even require some women to get blood transfusions.  

Science has historically overlooked diseases and conditions such as HMB that predominantly affect women, but one Georgia Tech researcher and his doctoral student are working to change that. 

“About 30 percent of women have heavy menstrual, and that can cause them to become anemic,” said David Ku, a Regents’ Professor in the George W. Woodruff School of Mechanical Engineering. “There are a lot of lost days where there's fatigue and embarrassment from bleeding too much, and the causes of that bleeding are poorly understood.” 

Ku, a faculty member in the Parker H. Petit Institute for Bioengineering and Bioscience, has received initial funding of $466,000 from Wellcome Leap to study whether clotting disorders contribute to HMB. The condition is most often attributed to hormone imbalances, leading many patients to receive treatments such as hormonal therapies that help manage symptoms. But in some cases, these treatments may treat symptoms while leaving an underlying bleeding disorder undiagnosed. 

“If a woman goes on the pill, it supposedly regulates the hormones and masks if there's a blood clotting problem,” Ku said. “If she has a clotting problem and doesn’t know it, she could run into other clotting problems if she has an injury or some type of trauma in the future. By diagnosing it properly, we can fix it properly.” 

As part of the study, Ku and his team of Chris Bresette, Minki Kang, and Raphaelle Dodart, are using a microfluidic blood-clotting test developed in the Ku laboratory to investigate whether clotting dysfunction contributes to heavy menstrual bleeding. This handheld instrument — which runs blood through a microfluidic tube about the width of a human hair — measures the speed of blood clotting and may open up possibilities for more personalized patient care. 

“We want to develop a point of care device that could allow gynecologists to diagnose the problem while the patient is visiting, as opposed to sending the blood off to the lab,” Ku said. “Currently, there is no good test for that. We’ve simplified the microscope system so that you can directly see whether the blood is clotting by going through that small tube.” 

Dodart, who was studying the mechanics of clotting and hypothesized the prevalence in HMB, is recruiting volunteers for the study. She is currently working with women who exhibit symptoms of HMB and are willing to give a small amount of blood to be tested through the diagnostic device. If her hypothesis around blood clotting is proven true, the study can expand further into the realm of treatment options.  

“The main goal now is that we identify a cause,” Dodart said. “In the future, hopefully we can focus on finding some solutions, some non-hormonal treatments, because we are looking for a treatable dysfunction.” 

The Wellcome grant could provide up to $1 million of total funding for the HMB study, spread out over three years. Though women’s health remains a largely underfunded area of science, the landscape is beginning to shift thanks to researchers like Ku and Dodart.  

“This is a widespread problem that not too many people have studied,” Ku said. “What we are studying is one of the treatable causes for heavy menstrual bleeding that we could actually change the outcome of right now.”