Bleeding Disorders Awareness Month: Heavy menstrual bleeding could indicate bleeding disorder

Drs. Magdalena Lewandowska and Sweta Gupta, Indiana Hemophilia & Thrombosis Center

Girls and women who suffer from heavy menstrual bleeding often do so in silence, brushing off their symptoms as normal. Many assume long periods or frequent pad and tampon changes (every 1-2 hours) are just part of being a woman, so they quietly grit through the inconveniences and count down the days until their cycles are over.

March is Bleeding Disorders Awareness Month, and we need to bust the longstanding myth that bleeding disorders only affect boys and men. In fact, girls and women can have bleeding disorders, and heavy menstrual bleeding (HMB) is a possible sign of an undiagnosed condition.

Certainly, excessive bleeding can negatively affect quality of life; some experience rushing to the restroom in the middle of meetings or outings, waking up at night due to excessive blood loss, feeling overly fatigued, and feeling alone in these and similar challenges. What’s more, if HMB is left untreated and a bleeding disorder remains undiagnosed, these women could face very serious risks if they happened to be in an accident, undergo surgery or experience a drug interaction.

There is a general lack of knowledge about what constitutes a normal amount of menstrual bleeding. Understanding what is not normal could save your life.

Heavy menstrual bleeding symptoms include:   

  • Period lasting longer than 7 days 
  • Soaking through a pad or tampon in 1-2 hours 
  • Passing clots larger than the size of a quarter 
  • Iron deficiency, anemia, or need for blood transfusion 
  • Missing days of school or work due to bleeding 

Other bleeding symptoms include:

  • Excessive bleeding after surgery, dental work or childbirth
  • Frequent and prolonged nosebleeds
  • Prolonged bleeding from cuts or wounds
  • Easy bruising
  • Family history of a bleeding disorder

Girls and women who experience any of these symptoms are encouraged to seek a medical evaluation and possible referral to a hematologist. The Girls & Women Only (GO) Clinic offered at The Indiana Hemophilia & Thrombosis Center (IHTC) in Indianapolis screens those with HMB for bleeding disorders. The GO Clinic is the only specialty clinic of its kind in the state of Indiana, offering girls and women with heavy menstrual bleeding or increased risk of developing blood clots (thrombosis) coordinated care by a hematologist and either adolescent medicine physician and/or gynecologist.

Evaluation and treatments offered at the GO Clinic include a work up for bleeding disorders with management as needed, anticoagulation management in patients with a history of thrombosis/clotting disorders, pelvic/full gynecological exam, and birth control evaluation as needed.

Comprehensive care and follow-up is provided at the IHTC if a bleeding disorder is diagnosed.

GO clinic physicians are also actively involved in multi-institutional collaborative research studies to better understand and further the care of women with bleeding disorders.

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