Related Experiment Video
Updated: Sep 17, 2025
Quantitating Iron Transport Across the Mouse Placenta In Vivo Using Nonradioactive Iron Isotopes
Published on: May 10, 2022
Evaluation of coagulation disorders and iron deficiency in women with heavy menstrual bleeding
Lucia Rugeri1,2, Yelena Fruchou2, Caroline Brodbeck2
1Service d'Hématologie Biologique et d'Hémostase Clinique, Hospices Civils de Lyon, Lyon, France.
Insights
Nearly 10% of women with heavy menstrual bleeding (HMB) have undiagnosed congenital bleeding disorders (CBD). Routine screening is vital for identifying these conditions and managing associated anemia effectively.
Area of Science:
- Gynecology
- Hematology
- Clinical Diagnostics
Background:
- Heavy menstrual bleeding (HMB) is a common gynecologic complaint.
- HMB can be a symptom of underlying congenital bleeding disorders (CBD).
- Anemia is a frequent complication of HMB and CBD.
Purpose of the Study:
- To determine the incidence of CBD in women referred for HMB.
- To assess the prevalence of anemia and iron deficiency in this cohort.
- To highlight the importance of screening for CBD in HMB management.
Main Methods:
- Prospective screening of 454 women referred for HMB over two years.
- Utilized Higham and ISTH-BAT scoring for blood loss assessment.
- Performed gynecologic ultrasound, coagulation tests, and complete blood counts.
Main Results:
- Identified 8 cases of CBD (1.8%) and von Willebrand Factor deficiency in 9.2% of women.
- Overt anemia (hemoglobin ≤120 g/L) found in 34.7% of participants.
- Iron deficiency (ferritin <15 μg/L) was present in 42.8% of women.
Conclusions:
- Laboratory screening revealed potential CBD in nearly 10% of women with HMB.
- At least 40% of women presented with overt or severe anemia.
- Reinforced the need for improved detection and management strategies for HMB and associated disorders.
Objective:
To explore the incidence of congenital bleeding disorders (CBD), which may result in anemia, in a large cohort of women referred for heavy menstrual bleeding (HMB) in a specialized gynecologic unit.
Methods:
Between January 2022 and January 2024, all women referred for HMB were screened. All benefited from Higham and ISTH-BAT scoring to assess the importance of blood loss. Gynecologic ultrasound was performed and antecedents were recorded. Standard coagulation tests, complete blood count, hemoglobin, ferritin, and C-reactive protein assays were performed.
Results:
Among 454 women, medical history disclosed eight cases of CBD (six von Willebrand diseases, one case of FVII deficiency and a CBD carrier). In the 446 others, coagulation tests identified 41 (9.2%) with von Willebrand Factor deficiency (VWF:GPAbR ≤ 50 IU/dL), very severe in three cases (0.7%). Overt anemia (hemoglobin ≤120 g/L) was found in 155 (34.7%) women, and low ferritin (<15 μg/L) in 191 (42.8%), with less than 30 μg/L for 324 patients (72.5%). Although the incidence of transfusions was limited, 341 (75.1%) of these women had received oral iron supplementation.
Conclusion:
Laboratory screening in a large series of women with HMB disclosed potential CBD in almost 10% of them and overt or rampant anemia in at least 40%. These observations support the need to reinforce the detection and management of HMB.
Related Concept Videos
01:24Disorders of Hemostasis
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
01:27Disorders of Erythrocytes
Erythrocyte disorders can be broadly categorized into two main types: anemic and polycythemic conditions.
A low oxygen-carrying capacity of the blood due to the loss, lower production, or destruction of erythrocytes is termed anemia. Hemorrhagic anemia, for example, occurs when bleeding from an external wound or internal ulcer reduces erythrocyte counts.
On the other...
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
01:30Venous Thrombosis IV: Nursing Management
01:22Hormonal Regulation of the Menstrual Cycle
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH...
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...