von Willebrand Disease and Other Inherited Bleeding Disorders in Women With Diagnosed Menorrhagia

Dilley, Anne; Drews, Carolyn; Miller, Connie H.; Lally, Cathy; Austin, Harland; Ramaswamy, Donna; Lurye, Donald; Evatt, Bruce L.

doi:10.1097/00006250-200104000-00028

Cited by 13 publications

(21 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The difference was statistically significant only in the larger study, which identified vWD in 6.6% of women with menorrhagia, compared to 0.8% of controls (odds ratio 8.6) [14]. In a separate analysis by race, vWD was significantly more frequent in white than African American women with menorrhagia (15.9% vs. 1.4%, respectively) [14,17]. The reason for the racial difference is unclear because population screening suggests a similar prevalence of vWD among different racial groups [1].…”

Section: Frequency Of Vwd In Women With Menorrhagiamentioning

confidence: 62%

“…Two studies including a contemporaneous control population found a higher frequency of vWD in women with menorrhagia. The difference was statistically significant only in the larger study, which identified vWD in 6.6% of women with menorrhagia, compared to 0.8% of controls (odds ratio 8.6) [14]. In a separate analysis by race, vWD was significantly more frequent in white than African American women with menorrhagia (15.9% vs. 1.4%, respectively) [14,17].…”

Section: Frequency Of Vwd In Women With Menorrhagiamentioning

confidence: 66%

“…Menorrhagia is a valuable predictor of a bleeding disorder in women. The frequency of vWD in women with menorrhagia ranges from 5% to 20% in different studies [10][11][12][13][14][15] (Table I). The different prevalences reported may reflect the different study populations (population based or referral), variable definitions of menorrhagia and vWD, timing, types of laboratory tests, and requirements for retesting.…”

Section: Frequency Of Vwd In Women With Menorrhagiamentioning

confidence: 99%

“…The frequency of vWD in adolescents with menorrhagia is not well defined, because most studies evaluating prevalence did not include adolescent women [10,[13][14][15]. Several small retrospective reviews identified vWD in 2.8-5% of adolescent women requiring urgent evaluation or hospitalization for menorrhagia [19,20].…”

Section: Frequency Of Vwd In Women With Menorrhagiamentioning

confidence: 99%

“…The criteria for diagnosis and frequency and timing of testing varied among the published studies (Table I). Studies requiring testing on only one occasion may underestimate the prevalence of vWD due to the normal fluctuation in vWF levels [11,13,14]. The three studies of women with objectively confirmed menorrhagia required testing on multiple occasions [10,12,15].…”

Section: Frequency Of Vwd In Women With Menorrhagiamentioning

confidence: 99%

See 4 more Smart Citations

von Willebrand's disease and menorrhagia: Prevalence, diagnosis, and management

Kujovich¹

2005

American J Hematol

View full text Add to dashboard Cite

The reported prevalence of von Willebrand's disease (vWD) is increased in women with menorrhagia, with current estimates ranging from 5% to 20%. The consistent results of multiple studies suggest testing should be included in the evaluation of patients with menorrhagia, especially in unexplained cases and prior to surgical intervention. Although a cyclic variation in von Willebrand's factor levels has not been confirmed, several studies suggest lower levels during menses and the early follicular phase. Menorrhagia is one of the most common bleeding manifestations of von Willebrand's disease, reported by 60-95% of women afflicted with this bleeding disorder. Menorrhagia is typically severe, often resulting in anemia and interfering with quality of life. Despite the frequency of menorrhagia, there is no consensus on optimal management. Although oral contraceptives are frequently prescribed, there are no studies confirming their efficacy using objective measures of response. Desmopressin was associated with an 80-92% response rate in several uncontrolled studies relying on patient assessment of efficacy. However, a small, randomized trial found no significant reduction in menstrual blood flow compared with placebo. There are anecdotal reports of the successful use of antifibrinolytic agents alone and in combination with other therapies. There are no studies comparing the relative efficacy and safety of the available medical therapies for von Willebrand's disease associated menorrhagia. Until these studies are completed, treatment should be individualized based on von Willebrand's disease subtype, patient age, contraceptive needs, and personal preference. Am.

show abstract

Section: Frequency Of Vwd In Women With Menorrhagiamentioning

confidence: 62%

Section: Frequency Of Vwd In Women With Menorrhagiamentioning

confidence: 66%

Section: Frequency Of Vwd In Women With Menorrhagiamentioning

confidence: 99%

Section: Frequency Of Vwd In Women With Menorrhagiamentioning

confidence: 99%

Section: Frequency Of Vwd In Women With Menorrhagiamentioning

confidence: 99%

See 3 more Smart Citations

von Willebrand's disease and menorrhagia: Prevalence, diagnosis, and management

Kujovich¹

2005

American J Hematol

View full text Add to dashboard Cite

show abstract

Abnormal Uterine Bleeding

Shavit¹,

Rabinovici²,

Carp³

2015

Progestogens in Obstetrics and Gynecology

View full text Add to dashboard Cite

Evaluation of a screening tool for bleeding disorders in a US multisite cohort of women with menorrhagia

Philipp

Faiz

Heit

et al. 2011

American Journal of Obstetrics and Gynecology

View full text Add to dashboard Cite

OBJECTIVE-The purpose of this study was to determine the usefulness of a simple screening tool for bleeding disorders in a multisite population of women with menorrhagia.STUDY DESIGN-Women with menorrhagia between the ages of 18 and 50 years from 6 geographically diverse US centers underwent hemostatic testing for bleeding disorders, complete blood cell count, and ferritin. A questionnaire that contained all elements of the 8-question screening tool was administered. Sensitivity of the screening tool, a screening tool with a pictorial blood assessment chart (PBAC) score of >185, and a screening tool with serum ferritin were calculated for hemostatic disorders.RESULTS-Two hundred and seventeen women who were identified with a PBAC score of ≥100 participated in the study. The sensitivity of screening tool was 89% for hemostatic defects, and sensitivity increased to 93% and 95% with a serum ferritin level of ≤20 ng/mL and PBAC score of >185, respectively.CONCLUSION-This study confirms the usefulness of a short screening tool for the stratification of women with menorrhagia for hemostatic evaluation. HHS Public AccessAuthor manuscript Am J Obstet Gynecol. Author manuscript; available in PMC 2015 October 08.Published in final edited form as: Am J Obstet Gynecol. 2011 March ; 204(3): 209.e1-209.e7. doi:10.1016/j.ajog.2010. Author Manuscript Author Manuscript Author Manuscript Author ManuscriptIt is estimated annually that approximately 5% of reproductive-age women seek medical attention for menorrhagia. 1,2 Underlying hemostatic abnormalities, which include decreased von Willebrand factor (VWF), platelet dysfunction, and decreased coagulation factors, are found commonly in women with menorrhagia. 1,3-5 Yet, most women with menorrhagia seek medical attention for their symptoms from gynecologists and primary care physicians, rather than from hematologists. Furthermore, few of these women are referred for hemostatic evaluation, despite the high prevalence of hemostatic abnormalities in this population 6 ; the average delay from onset of bleeding symptoms to diagnosis of a bleeding disorder has been reported to be 16 years. 7 Barriers to referral for hemostatic evaluation include difficulties gynecologists and primary care physicians have in determining whom to refer, lack of recognition by gynecologists and primary care physicians of menorrhagia as a symptom of a bleeding disorder, the size of the population with complaints of menorrhagia, and the lack of simple laboratory tests to screen for hemostatic abnormalities in this population. Given the under-recognition and delay in diagnosis of bleeding disorders and the potential for bleeding complications with surgery, childbirth or invasive procedures in women with menorrhagia, and unidentified bleeding disorders, a standardized screening tool to assist in the determination of which women to refer for hemostatic evaluation would be useful for the practicing gynecologist. Using data from women with menorrhagia at a single institution, a simple easy-to-administer sc...

show abstract

von Willebrand Disease and Other Inherited Bleeding Disorders in Women With Diagnosed Menorrhagia

Cited by 13 publications

References 22 publications

von Willebrand's disease and menorrhagia: Prevalence, diagnosis, and management

von Willebrand's disease and menorrhagia: Prevalence, diagnosis, and management

Abnormal Uterine Bleeding

Evaluation of a screening tool for bleeding disorders in a US multisite cohort of women with menorrhagia

Contact Info

Product

Resources

About