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
