A team from the Mary M. Gooley Hemophilia Center/Lipson Blood and Cancer Center in Rochester, New York, recently published the results of a study to determine the incidence of hemostasis disorders among adolescent girls referred for unusually heavy and prolonged menstrual bleeding (menorrhagia). After conducting a retrospective, medical record review of 61 consecutive adolescent women with menorrhagia, ages 11-19, researchers found that 22 (36%) were diagnosed with von Willebrand disease (VWD), four (7%) with a platelet function disorder (PFD) and one patient with both.
Overall, more than 40% of patients referred to the center had an underlying hemostasis disorder, further confirming the prevalence of these conditions nationwide and the need for more/additional screening among this population. “Our results confirm the previously published data highlighting the importance of evaluating adolescents with heavy menstrual bleeding for an underlying bleeding disorder,” explained study authors.
The review also detailed manifestations of early bleeding symptoms in the 25 VWD and PFD patients. A menorrhagic first period was experienced by 11 (44%); nose bleeds, also known as “epistaxis,” occurred in six (24%); easy bruising in eight (32%); bleeding of the gums in seven (28%); and excessive bleeding with procedures in three (12%) patients. Records indicated that the preliminary referrals of these adolescents were made most often by pediatricians and gynecologists, in 11 women respectively. Two patients were referred to the center by their dentist and one by her family physician.
In light of the incidence of disorders such as VWD, the authors reiterated that hemophilia treatment centers (HTCs) must continue to play a decisive role in testing adolescent patients with menorrhagia. They also included a caveat--that an HTC evaluation must be followed with/by a determination of the best possible treatment. “Identification of these patients, however, is only the ‘first’ step in the care of these patients,” said study authors. To that end, the Mary M. Gooley Center as well as other HTCs are actively studying “optimal management” of this patient population.
The study, “The Prevalence of Disorders of Haemostasis in Adolescents with Menorrhagia Referred to a Haemophilia Treatment Centre,” was published in the September 2007 issue of Haemophilia.
Source: Women’s Health Weekly, October 11, 2007