Disorders of hemostasis as the main pathogenetic mechanism in the development of menopausal abnormal uterine bleeding

Abstract

The article presents our own clinical observations of cases of abnormal uterine bleeding in postmenopausal women, where the main cause was the pathology of hemostasis: a patient after liver transplantation for cirrhosis with chronic viral hepatitis C, and a patient with primary idiopathic thrombocytopenic purpura which manifested at a later age. Among the most common causes of abnormal uterine bleeding in postmenopausal women are hyperplasia and endometrial cancer, leiomyoma, are adenomyosis are distinguished. Pathology of the hemostasis system as the main cause of abnormal uterine bleeding, prevails in the pubertal and reproductive period. In the literature available we did not find any publications concerning uterine bleeding in postmenopausal patients against the background of the pathology of the blood coagulation system. This article illustrates the significance of hemostasis disorders both secondary and primary in the origin of abnormal bleeding in postmenopausal period. Careful collection of anamnesis, an indication of the occurrence of petechial rash, gingival bleeding should alert the doctor. It should also be remembered that “suddenly arisen” immune cytopenias and late-onset thrombosis are often manifestations of the hematological paraneoplastic syndrome and require the exclusion of neoplasia, first of all, of the hematopoietic system. These clinical observations allow recommending a mandatory examination of the hemostatic system in patients with postmenopausal bleeding.