Integrating Hereditary Hemorrhagic Telangiectasia into the Diagnostic Workup of Adolescent Heavy Menstrual Bleeding

To understand the effect of hereditary hemorrhagic telangiectasis (HHT) on uterine bleeding is paramount to improving clinical care of menstruating individuals with HHT. Heavy menstrual bleeding (HMB) in adolescents and young adults (AYAs) with HHT is underrecognized and among individuals with HMB, HHT should be considered in the differential diagnosis, especially among those with suggestive clinical features or family history. Stigmatization associated with vaginal blood loss likely contributes to the paucity of evidence to guide HMB management in individuals with HHT, as previously reported in von Willebrand disease and other inherited bleeding disorders.