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Mohamed Sikkander Abdul Razak: Clinical Steps for Evaluating and Managing Heavy Menstrual Bleeding
Mohamed Sikkander Abdul Razak/LinkedIn
Apr 6, 2026, 10:03

Mohamed Sikkander Abdul Razak: Clinical Steps for Evaluating and Managing Heavy Menstrual Bleeding

Mohamed Sikkander Abdul Razak, Professor at GKM College of Engineering Technology, shared a post on LinkedIn:

“Clinical steps for evaluating and managing heavy menstrual bleeding (HMB):

1. Initial assessment:

  • Detailed history (menstrual pattern, bleeding severity, iron deficiency, family history of bleeding disorders).
  • Physical exam to rule out structural causes (e.g., fibroids).

2.Laboratory evaluation:

  • Complete blood count (CBC) to check for anemia.
  • Iron studies (serum ferritin, iron levels).
  • Coagulation screening: PT, aPTT, von Willebrand factor (vWF) antigen/activity, platelet function tests.

3. Identify underlying hemostatic defect:

  • Confirm vWD or platelet dysfunction (most common causes).
  • Assess for factor deficiencies if indicated.

4.Management strategies:

Medical therapy:

  • Hormonal treatments (combined oral contraceptives, levonorgestrel IUS) to regulate cycles and reduce bleeding.
  • Antifibrinolytics (tranexamic acid) during menses to stabilize clots.

Hemostatic therapy:

  • vWF concentrates or DDAVP for vWD.
  • Platelet transfusions or specific factor replacement if needed.

Surgical options:

  • Endometrial ablation or hysterectomy in refractory cases.

5. Pregnancy planning:

  • Preconception counseling and hemostatic optimization to prevent miscarriage or postpartum hemorrhage.
  • Specialist referral for individualized risk assessment.

6.Follow‑up:

  • Monitor hemoglobin and iron levels.
  • Re‑evaluate hemostatic workup if bleeding persists or complications arise.”

Mohamed Sikkander Abdul Razak: Clinical Steps for Evaluating and Managing Heavy Menstrual Bleeding

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