Gynecology

Joanna Davies, Rezan A. Kadir
In: Inherited Bleeding Disorders in Women 2e · 2018 · pp. 45–64 · doi:10.1002/9781119426080.ch4 · W4254960123
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Gynecological bleeding, particularly heavy menstrual bleeding, is a frequent and underestimated symptom in women with inherited bleeding disorders, often managed with progestogens or ulipristal acetate, and can be linked to ovarian cysts or endometriosis.

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Abstract

The frequency and severity of gynecological bleeding have long been underestimated in women with inherited bleeding disorders (IBDs). Heavy menstrual bleeding (HMB) is the most common presenting symptom for women with IBD. Menstrual blood loss can be recorded with a high degree of accuracy using the alkaline hematin method. Hemostasis plays an important part in the control of the bleeding. Therefore, hemostatic abnormalities are commonly associated with excessive or prolonged menstruation. Oral progestogens are one of the most commonly prescribed medications for HMB. Ulipristal acetate (UPA) is a selective progesterone receptor modulator that is clinically proven to reduce the size of uterine fibroids, reduce menstrual loss, or induce amenorrhea in women with fibroids. Recurrences of hemorrhagic ovarian cysts can be a manifestation of undiagnosed bleeding disorder and girls/women with such presentation should be referred for a thorough hemostatic assessment. Endometriosis is a common gynecological problem caused by deposition of ectopic endometrial glands and stroma.

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Condition tags

endometriosis

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