By Sandy Smith
Women with bleeding disorders are reminded of that fact on a fairly regular basis: whenever their monthly period occurs.
Almost 80 percent of women with a bleeding disorder report heavy menstrual bleeding, according to Beverly Schaefer, MD, pediatric hematologist and clinical assistant professor at University of Buffalo. Schaefer is joined by Shaveta Malik, MD, her colleague at Western New York BloodCare and the University of Buffalo, for the session Reproductive Health and Pregnancy.
But it is not just the monthly cycle that creates increased risk for women with bleeding disorders. Pregnancy, particularly with post-partum hemorrhaging or after miscarriage, also carries a higher-than-average risk of heavy bleeding.
“Bleeding has a lot more consequences than our physical health,†Schaefer says in the prerecorded session. “Women with heavy periods miss a fair amount of school or work, and that has its own added costs.â€
During the session, Schaefer and Malik cover the use of hormone therapies and intrauterine devices (IUDs) to manage bleeding. But they also remind the viewing audience that there’s no “one-size-fits-all†solution.
“It’s really important that we address treatment options and that we take each person individually to help find them best fit for them,†Schaefer says. “A treatment that works well for one woman may not work as well for another, even within families. There can be some troubleshooting involved.â€
The session explores recommendations for preconception counseling, as well as amniocentesis or chorionic villi sampling to determine whether a fetus has a bleeding disorder. Those who become pregnant are advised to consult with a high-risk pregnancy physician, make more frequent obstetrics appointments, and have more frequent contact with the hematologist. Delivery should be in a facility that has a high-risk pregnancy physician and hematologist on staff, as well as a pharmacy that stocks blood products.
Women with bleeding disorders also tend to have a higher rate of uterine issues like fibroids, endometriosis or uterine polyps. “If you notice there is a change in what your period looks like, it does trigger a workup or pelvic ultrasound to look for other abnormalities,†Malik says. “Do not ignore a change in symptoms.†â–
