Objective: To assess the impact of skeletal muscle ryanodine receptor ( RYR1) variants, a common cause of neuromuscular disorders, on smooth muscle function, bleeding, obstetric, and gynaecological outcomes. Design: Questionnaire study. Setting: Online via the RYR1-Foundation patient support group covering countries across the world. Population or Sample: 154 women consisting of 66 RYR1-variant carrying participants and 88 controls. Methods: Online questionnaire designed to investigate symptoms of abnormal smooth muscle function, obstetric and gynaecological outcomes in women with RYR1 variants. Questions were developed using a modified version of the MCMDM-1VWD questionnaire, and the NHS-heavy periods self-assessment tool. Obstetric and gynaecological symptoms explored include pregnancy-related complications, gestation length, parturition duration, post-partum haemorrhage and offspring birthweight. Main Outcome Measures: Bleeding scores were measured using a modified MCMDM-1VWD scale. Significance between groups were analysed using Fisher exact tests, Chi Square tests, and Welch’s t-tests. Results: Women with RYR1 variants exhibited a higher incidence of pathological bleeding scores (p<0.0001), severe menstrual bleeding, complications during pregnancy (preeclampsia and placenta praevia), post-partum haemorrhage, shorter pregnancies, frequent planned Caesarean sections, and offspring with lower birthweight, compared to controls. Gastrointestinal symptoms were also more common. Conclusions: RYR1 mutated females exhibit a bleeding disorder and frequent gynaecological and obstetric complications. Considering their population frequency in otherwise pauci-symptomatic individuals, RYR1 variants ought to be considered as a cause of otherwise unexplained menorrhagia and other gynaecological and obstetric manifestations. Funding: King’s Health Partners Institute of Women and Children’s Health Keywords: skeletal muscle ryanodine receptor (RYR1) gene; questionnaire; bleeding; menorrhagia; post-partum haemorrhage Tweetable abstract: RYR1 mutated females exhibit a bleeding disorder. RYR1 variants ought to be considered as a cause of otherwise unexplained menorrhagia, PPH and obstetric complications.