Kouides et al listed indications for testing a woman with excessive menstrual bleeding for a disorder of hemostasis. The authors are from the University of Rochester.

Patient selection: abnormal menstrual bleeding


Indications to evaluate the woman for a coagulopathy"

(1) heavy menstrual bleeding since menarche

(2) postpartum hemorrhage

(3) surgery-related bleeding

(4) excessive bleeding associated with dental work

(5) 2 or more of the following:

(5a) bruising (1-2 times per month)

(5b) epistaxis (1-2 times per month)

(5c) frequent bleeding gums

(5d) family history of bleeding symptoms


The workup may include:

(1) consult with a hematologist

(2) screen for von Willebrand disease

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