Related Experiment Videos
Evaluation of abnormal bleeding in women
1Rochester General Hospital, 1425 Portland Avenue, Rochester, NY 14621, USA. peter.kouides@viahealth.org
Current Hematology Reports
|August 7, 2003
Summary
Evaluating women with heavy menstrual bleeding (menorrhagia) often reveals underlying hemostatic disorders like von Willebrand disease or impaired platelet aggregation. Early diagnosis improves quality of life and avoids unnecessary surgeries.
Area of Science:
- Hematology
- Gynecology
Background:
- Abnormal uterine bleeding, specifically menorrhagia, frequently indicates an underlying hemostatic disorder.
- Von Willebrand disease affects an estimated 7-20% of women with menorrhagia, while impaired platelet aggregation may be present in 20-30%.
Purpose of the Study:
- To outline the diagnostic approach for identifying hemostatic disorders in women presenting with menorrhagia.
- To highlight key symptoms and laboratory tests for accurate diagnosis.
Main Methods:
- Detailed patient history including menstrual flow assessment (pictorial charts, pad usage, work/school days missed).
- Inclusion of bleeding symptom audit focusing on menorrhagia since menarche, surgical/dental bleeding, and postpartum hemorrhage.
- Comprehensive laboratory testing including CBC, coagulation profiles, factor VIII, von Willebrand factor assays, and platelet aggregation studies.
Main Results:
- Specific bleeding history elements (menarche-related menorrhagia, surgical/dental bleeding, postpartum hemorrhage) are predictive of von Willebrand disease.
- Epistaxis and easy bruising are not reliable indicators.
- A range of hemostatic disorders, including von Willebrand disease, platelet dysfunction, and fibrinolysis issues, can cause menorrhagia.
Conclusions:
- Timely diagnosis of hemostatic disorders in women with menorrhagia is crucial.
- Undiagnosed disorders can lead to persistent menorrhagia, reduced quality of life, and potentially risky surgical interventions.