Heghine Khachatryan: Heavy Menstrual Bleeding is Not ‘Normal’ – It is Often Missed Pathology
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:
“Heavy menstrual bleeding is not ‘normal’ — it is often missed pathology.
For too long, heavy menstrual bleeding (HMB) has been normalized, underestimated, and frequently misdiagnosed.
Behind what is often dismissed as a ‘gynecological issue,’ there may be an underlying hemostatic disorder — including von Willebrand disease, platelet function defects, or other coagulation abnormalities.
The clinical reality is concerning:
Many women remain undiagnosed for years, presenting later with anemia, perioperative bleeding, or complications during pregnancy and childbirth.
Pregnancy introduces an additional layer of complexity.
Hemostasis is dynamically altered, and in women with unrecognized bleeding disorders, this may result in:
- increased risk of miscarriage
- postpartum hemorrhage
- preventable maternal morbidity
Misdiagnosis is not benign — it is systemic failure.
We must shift from symptom-based reassurance to structured hemostatic evaluation, especially in:
- adolescents with HMB
- women with iron deficiency
- patients with bleeding history prior to surgical or reproductive interventions
This is not only a clinical issue — it is a matter of health equity, awareness, and diagnostic capacity.
The time has come to integrate hemostasis into routine women’s health assessment — not as an exception, but as a standard.”
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