Heghine Khachatryan: When Bleeding Speaks – Think Beyond Gynecology
Heghine Khachatryan, Editor-in-Chief of Hemostasis Today, Head of Hemophilia and Thrombosis Center at Yeolyan Hematology and Oncology Center, shared a post on LinkedIn:
“When Bleeding Speaks – Think Beyond Gynecology
Heavy menstrual bleeding is not just a symptom – it is a diagnostic signal.
Up to 24% of women with HMB may have von Willebrand disease, the most common inherited bleeding disorder – yet often missed.
Red Flags
- Menorrhagia from menarche
- Bleeding more than 7 days
- Iron deficiency anemia
- Postpartum/surgical bleeding
Family history
- Not symptoms – diagnostic alarms
- Think VWD When
- Bleeding is disproportionate
- Treatment response is poor
- Multisite bleeding exists
- Pregnancy is complicated
Approach
Don’t treat in silos
- Hematology plus Gynecology
- vWF testing (activity, antigen, FVIII)
- Risk assessment before surgery/pregnancy
Treatment is equal to Mechanism minus Based
- Hormonal therapy
- Tranexamic acid
- DDAVP / vWF concentrates
Core Message
- Treating bleeding alone is equal to incomplete care
- Identifying cause is equal to changing outcomes
Final Thought
Every unexplained bleeding in a woman deserves a hemostasis workup.
Because sometimes,
‘just a period’ is a missed diagnosis.”
Salih Ehsan, Chief Executive Officer at Kulsoom Society of hematology, shared Heghine Khachatryan’s post on LinkedIn, adding:
“During HMB, a history of multi site bleeding (gum bleeding, Epistaxis , injection site bruising, purpuric skin rashes) , history of recurrent mucocutaneous bleeding since childhood.
Family history of disproportionate bleeding ( in male and female also) are very helpful to suspect vWD.
Most common and under diagnosed bleeding disorder in Gynecology.
Even if a male child with hemophilia, always take a gynecology history from his mother also.”
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