Management of heavy menstrual bleeding in women with bleeding disorders in a tertiary care center

Kuthiala, Shikha; Grabell, Julie; Relke, Nicole; Hopman, Wilma M.; Silva, Mariana; Jamieson, Mary Anne; James, Paula

doi:10.1016/j.rpth.2023.100119

Cited by 10 publications

(8 citation statements)

References 24 publications

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“…For example, a recent observational study reported that only 68% of an IBD patient cohort gained satisfactory control of their HMB with medical management. 40 It is well recognized that women with HMB and IBD will commonly fail first line, or even second line therapies. Furthermore, high-quality evaluation of specific treatment for IBD and HMB are few.…”

Section: Optimal Therapymentioning

confidence: 99%

“…It is important to recognize that even when a patient is diagnosed with an IBD and suffers with HMB, this does not guarantee a greater likelihood of successful treatment/reduction of menstrual blood loss. For example, a recent observational study reported that only 68% of an IBD patient cohort gained satisfactory control of their HMB with medical management 40 . It is well recognized that women with HMB and IBD will commonly fail first line, or even second line therapies.…”

Section: Heavy Menstrual Bleeding: From Menarche To Menopausementioning

confidence: 99%

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Women and girls with inherited bleeding disorders: Focus on haemophilia carriers and heavy menstrual bleeding

Hermans,

Johnsen,

Curry

2024

Haemophilia

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Raising awareness and improving recognition, accurate classification, and enhanced access to new treatments represent current key challenges for carriers of haemophilia. Women and girls carrying genes for haemophilia often experience significant bleeding and/or low factor levels. The bleeding associated with female haemophilia is frequently overlooked, has a weak correlation with factor levels, and manifests differently than in males, with heavy menstrual bleeding being a predominant symptom. Recent changes in terminology now allow the diagnosis of haemophilia in females with low factor levels and differentiate between symptomatic and asymptomatic carriers of the gene.Observations from real‐world experiences and limited clinical trial data have highlighted the positive impact of various new haemophilia treatments for women and girls with clotting factor deficiencies. There is an urgent need for initiatives that increase their access to these treatments and encourage well‐designed clinical trials focusing on female‐specific outcomes.In women with inherited bleeding disorders, early recognition and optimal management of heavy menstrual bleeding are crucial. However, treatment options and guidance from high‐quality clinical trials are currently insufficient. Menstrual health assessment should be a regular part of monitoring women and girls with inherited bleeding disorders throughout their lives, emphasizing the importance of gathering data to improve future management.

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Section: Optimal Therapymentioning

confidence: 99%

Section: Heavy Menstrual Bleeding: From Menarche To Menopausementioning

confidence: 99%

Women and girls with inherited bleeding disorders: Focus on haemophilia carriers and heavy menstrual bleeding

Hermans,

Johnsen,

Curry

2024

Haemophilia

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“…Initial treatment recommendations do not vary from individuals without IBD; however, achieving HMB suppression can be challenging. 2,9,10 One cohort study found that about half (46.4%) of adolescents with IBD failed their initial menstrual suppression therapy. 11 Another study found that only 17% of women with HMB and IBD were satisfied with their menstrual control on first-line therapy.…”

Section: Introductionmentioning

confidence: 99%

“…Centers of Excellence are multidisciplinary clinics consisting of both hematologists and women's health specialists (gynecologists or adolescent medicine physicians); they have increased in numbers throughout the United States to provide specialized care to this cohort. Initial treatment recommendations do not vary from individuals without IBD; however, achieving HMB suppression can be challenging 2,9,10 . One cohort study found that about half (46.4%) of adolescents with IBD failed their initial menstrual suppression therapy 11 .…”

Section: Introductionmentioning

confidence: 99%

“…One cohort study found that about half (46.4%) of adolescents with IBD failed their initial menstrual suppression therapy 11 . Another study found that only 17% of women with HMB and IBD were satisfied with their menstrual control on first‐line therapy 10 . This study aims to characterize the care at a large multidisciplinary clinic, identifying optimal strategies for menstrual suppression and reasons for treatment failure.…”

Section: Introductionmentioning

confidence: 99%

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Adequate menstrual suppression in adolescents with inherited bleeding disorders often requires multiple treatment changes: Retrospective cohort study of a multidisciplinary clinic

Brown,

Tickle,

Woods

et al. 2024

Pediatric Blood & Cancer

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Heavy menstrual bleeding (HMB) is often the presenting symptom for females with inherited bleeding disorders (IBD). Multidisciplinary clinics leverage the expertise of hematologists and women's health specialists. This study characterizes the complexity of HMB management for adolescents with IBDs from a large multidisciplinary clinic. Adolescents often required multiple different menstrual suppression treatments, with only about 20% achieving acceptable suppression with their first treatment. Adolescents switched therapy most often for uncontrolled bleeding, followed by adverse effects, and patient preference. Given the difficulty in achieving adequate menstrual suppression, multidisciplinary clinics offer necessary expertise in accomplishing bleeding control with minimal adverse effects.

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Menstrual suppression to decrease intrauterine device expulsion in adolescents with inherited bleeding disorders

Cygan,

Kons,

Fiorillo

et al. 2024

Intl J Gynecology & Obste

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Management of heavy menstrual bleeding in women with bleeding disorders in a tertiary care center

Cited by 10 publications

References 24 publications

Women and girls with inherited bleeding disorders: Focus on haemophilia carriers and heavy menstrual bleeding

Women and girls with inherited bleeding disorders: Focus on haemophilia carriers and heavy menstrual bleeding

Adequate menstrual suppression in adolescents with inherited bleeding disorders often requires multiple treatment changes: Retrospective cohort study of a multidisciplinary clinic

Menstrual suppression to decrease intrauterine device expulsion in adolescents with inherited bleeding disorders

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