Abstract
Heavy menstrual bleeding (HMB) affects almost 18 million women in the United States, leading to a loss of quality of life and decreased productivity. The Levonorgestrel Intra Uterine System is a highly effective first line treatment in reducing blood loss in HMB. However, the exact mechanism by which it affects the coagulation cascade remains unknown. The plasminogen activator system is an important pathway that controls fibrin clot formation and dissolution through regulation of plasmin. Very little is known about the role of this system in HMB.
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