Reproductive Health and Women with Rare Coagulation Disorders

Treating Menorrhagia

We know so many women with ultra-rare bleeding disorders who have had their periods permanently suppressed, or an early hysterectomy, due to heavy menstrual bleeding.

Q: What are your thoughts on managing menorrhagia throughout various stages of the menstrual cycle?

There is little guidance - mostly case reports. Given this fact these are my main thoughts:

1. Finding a GYN provider who is willing to work with you is paramount.

2. This person needs to understand that causes of menorrhagia are multifaceted and thus the approach needs to be multipronged. This person needs to be open to talking to hematology on a regular basis as well. The combination heme/GYN clinics have been so important in addressing the needs of women with rare disorders.

3. Often what works for some time stops working and needs to be changed and women need to be open to trying different combinations of therapy. It can be a frustrating situation as things change and women often feel alone.

There are a wealth of other estrogen-free options that are fantastic at managing heavy menses – such as the hormonal IUD.

It is important to remember that the progesterone only IUDs are excellent at controlling heavy bleeding, and very safe in all age women. They do not increase the risk of blood clots.