A bleeding array is a health problem that makes it difficult for a person to stop bleeding. So As many as one in 10 menstruating women may experience bleeding disorders. So If left untreated, bleeding disorders put you at increased risk of anemia and dangerous bleeding after childbirth. But Menorrhagia, or heavy menstrual bleeding, is a common medical problem affecting women of reproductive age. However, in 50% of cases, the cause cannot be determined. So Von Willebrand disease (VWD) or other bleeding disorders may be the underlying cause of heavy bleeding. Women with menorrhagia and/or VWD are at increased risk for several conditions, including anemia, bleeding during pregnancy, postpartum hemorrhage, and reduced quality of life (OOL). But Women’s Bleeding Disorders
Diagnosis
Proper diagnosis and management can reduce complications and unnecessary surgical interventions. But the Division of Blood Disorders (DBD) at the Centers for Disease Control and Prevention (CDC) investigated physician awareness of bleeding disorders, established prevalence in the United States, and determined optimal treatment options. But What is the implementation of studies? So An 18-year-old woman is seeking medical attention from her rural family physician for heavy menstrual periods. They usually last 8 to 10 days, with the heaviest bleeding on days 2 and 3. She has struggled with iron deficiency since menopause and had profuse bleeding after having her wisdom teeth extracted at age 14, which required a return visit to the dentist. But She does not have a family history of bleeding disorders. So Women’s Bleeding Disorders
Signs and symptoms of bleeding disorders:
- May include heavy bleeding during menstruation (period).
- Bleeding lasts more than 7 days from the time the bleeding starts until it stops.
- bleeding or bleeding that limits daily activities, such as work, school, exercise, or social activities;
- passing large clots from grapes; So
- Soak a tampon or pad every hour but more often on the heaviest day(s)
- So Getting an “iron deficiency” diagnosis or treatment for anemia.
- Symptoms may include easy but frequent bleeding.
- Nosebleeds that occur for no apparent reason and last longer than 10 minutes or that require medical attention.
- A simple injury that occurs without but physical injury.
- heavy bleeding after so medical procedure or tooth extraction; And
- A history of bleeding from muscles but joints without any physical injury.
- Having one or more of the above bleeding symptoms and having a family member with a bleeding disorder, such as von Willebrand disease or hemophilia.
Types of Bleeding
| Types of Bleeding | 0 | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Epistaxis | None/trivial | >5 per year or more than 10 min | Consultation only | Packing, cauterization, or antifibrinolytics | Blood transfusion or replacement therapy (use of hemostatic blood components or rFVIIa) or desmopressin |
| Cutaneous | None/trivial | ≥5 bruises (>1 cm) in exposed areas | Consultation only | Extensive | Spontaneous hematoma requiring blood transfusion |
| Bleeding from minor wounds | None/trivial | >5 per year or more than 10 min | Consultation only | Surgical hemostasis | Blood transfusion, replacement therapy, or desmopressin |
| Oral cavity | None/trivial | Present | Consultation only | Surgical hemostasis or antifibrinolytics | Blood transfusion, replacement therapy, or desmopressin |
| Gastrointestinal bleeding | None/trivial | Present (not associated with an ulcer, portal hypertension, hemorrhoids, angiodysplasia) | Consultation only | Surgical hemostasis, antifibrinolytics | Blood transfusion, replacement therapy, or desmopressin |
| Hematuria | None/trivial | Present (macroscopic) | Consultation only | Surgical hemostasis, iron therapy | Blood transfusion, replacement therapy, or desmopressin |
| Tooth extraction | None/trivial or none performed | Reported in ≤25% of all procedures, no intervention | Reported in >25% of all procedures, no intervention | Resuturing or packing | Blood transfusion, replacement therapy, or desmopressin |
| Surgery | None/trivial or none performed | Reported in ≤25% of all procedures, no intervention | Reported in >25% of all procedures, no intervention | Surgical hemostasis or antifibrinolytics | Blood transfusion, replacement therapy, or desmopressin |
| Menorrhagia | None/trivial | Consultation only or changing pads more frequently than once every 2 hours or clot and flooding or pictorial bleeding assessment chart score >100 | Time off work or school more than twice per year or requiring antifibrinolytics or hormonal or iron therapy | Requiring combined treatment with antifibrinolytics and hormonal therapy or present since menarche and for more than 12 months | Acute menorrhagia requires admission and emergency treatment or requires blood transfusion, replacement therapy, desmopressin, or requiring dilatation and curettage or endometrial ablation, or hysterectomy |
| Postpartum hemorrhage | None/trivial or no deliveries | Consultation only or use of syntaxin or lochia for >6 weeks | Iron therapy or antifibrinolytics | Requires blood transfusion, replacement therapy, desmopressin, or requiring examination under anesthesia and/or the use of a uterine balloon or package to tamponade the uterus | Any procedure requiring critical care or surgical intervention (eg, hysterectomy, internal iliac artery ligation, uterine artery embolization, uterine brace sutures |
| Muscle hematomas | Never | Posttrauma, no therapy | Spontaneous, no therapy | Spontaneous or traumatic, requiring desmopressin or replacement therapy | Spontaneous or traumatic, requiring surgical intervention or blood transfusion |
| Hemarthrosis | Never | Posttrauma, no therapy | Spontaneous, no therapy | Spontaneous or traumatic, requiring desmopressin or replacement therapy | Spontaneous or traumatic, requiring surgical intervention or blood transfusion |
| Central nervous system bleeding | Never | — | — | Subdural, any intervention | Intracerebral, any intervention |
| Another bleeding | None/trivial | Present | Consultation only | Surgical hemostasis, antifibrinolytics | Blood transfusion or replacement therapy or desmopressin |
Causes of Women’s Bleeding Disorders
Usually, bleeding disorders are inherited, passed from parent to child when you are born. But it’s possible to have a bleeding disorder even if your parents didn’t. So Talk to your doctor or nurse about the risks if you have a family history of bleeding disorders.
Sometimes, bleeding disorders can be caused but other health problems or medications you take:
- Liver disease. So Your liver makes most of the clotting factors (proteins in the blood) that you need.
- Kidney disease, especially in advanced stages
- Side effects of certain medications, such as blood thinners (anticoagulants), certain pain medications, or long-term use of antibiotics
- Thyroid hormone imbalance
Treatment of Women’s Bleeding Disorders
There is no cure for bleeding disorders, but for many people, medication can help control symptoms. People with light bleeding problems may only need treatment before or after surgery and dental work, or after an injury. But If your symptoms are more severe, you may need to take the medicine more often.
Common treatments for bleeding disorders include:
- Birth control. Hormonal birth control methods, such as the pill, patch, shot, vaginal ring, and hormonal intrauterine device (IUD), increase the number of certain clotting factors in your blood. They can also control heavy periods in women with certain bleeding disorders.
- Iron supplements. So If you are anemic and don’t have enough iron in your blood, you may need iron supplements to bring your red blood cell levels back to normal.
- Hormones. Your doctor may give you a hormone called desmopressin acetate (DDAVP) if you have certain bleeding disorders, such as von Willebrand disease or Hemophilia DDAVP helps your body release stored clotting factors from your blood. But DDAVP can prevent heavy periods and nosebleeds. It can also be used before surgery or to stop bleeding. So You can get DDAVP as a nasal spray.
- Antifibrinolytics (an-teye-FEYE-bruhn-uhl-IHT-ihks) These drugs prevent blood clots from breaking down too quickly before they heal. But This can be a problem in some bleeding disorders. If you have a bleeding array, your doctor may give you antifibrinolytics before dental work, to stop nosebleeds, or to control heavy periods. So You can take antifibrinolytics as a pill or with liquid.
- The clotting factor is concentrated. But You may need this medicine if you do not have enough blood proteins or clotting factors in your blood. So Adding these proteins to the blood stops or controls bleeding. So Different clotting factors treat different types of bleeding disorders. This type of treatment is used after surgery, serious injury, or when other treatments don’t work. But The clotting factor must be given through an intravenous (IV) tube.