Heavy Menstrual Bleeding

Abstract

Heavy menstrual bleeding (HMB), a common complaint in adolescent and adult women, can be due to a variety of causes such as anovulatory bleeding, bleeding disorders, anticoagulant and antiplatelet medication intake, endocrine abnormalities, infectious etiology, pregnancy/miscarriage, and anatomic abnormalities of the reproductive organs. Comprehensive evaluation of the patient by the gynecologist and hematologist working in conjunction will enable prompt detection of the underlying cause and timely institution of therapy. In general, HMB can be managed with hormonal therapy and hemostatic therapy; in patients with bleeding disorders, specific hemostatic therapy directed toward the underlying disorder can be given as primary or supplemental therapy. Appropriate medical or interventional therapy for other etiologies and management of hematologic and gynecologic complications of HMB will help to improve the patient’s overall quality of life. Patient-centered efforts and use of innovative technology for HMB can enhance patient awareness and education and promote participation in their care.