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Abdul Mannan: Two Battles, One Patient – Why Women on Anticoagulants Need Better Coordinated Care

Dr Abdul Mannan/LinkedIn

Dec 10, 2025, 23:50

Abdul Mannan: Two Battles, One Patient – Why Women on Anticoagulants Need Better Coordinated Care

Abdul Mannan, Consultant Haematologist at Betsi Cadwaladr University Health Board, shared a post on LinkedIn:

“Too many young females on anticoagulants are fighting two battles at once:
the clot… and their periods.

Our new BloodDoctor infographic highlights a problem that still flies under the radar:

Up to 60% of patients on blood thinners experience gynaecologic bleeding.
For many, it’s not just inconvenient — it leads to iron deficiency, anaemia, and in some cases, life-threatening haemorrhagic ovarian cysts.
What struck me most while creating this resource is how often these patients end up navigating it alone, without joined-up support between haematology and gynaecology.

The evidence is clear:

1. Bleeding risk varies by drug type.
Vitamin K antagonists: 22–71%
Rivaroxaban: up to 43%

2. Multidisciplinary care changes outcomes.

The safest and most effective approach brings together:
• Haematology
• Gynaecology / Adolescent Medicine
• Primary Care
• A coordinated clinic model where decisions are shared rater than made in isolation.

When these teams work together, patients avoid the unnecessary suffering created by abrupt contraceptive changes, untreated heavy bleeding, and delayed referrals.
This is a call for better collaboration, not more complexity.