Heghine Khachatryan/LinkedIn
Apr 7, 2026, 14:36
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 >7 daysIron 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 and Gynecology
- vWF testing (activity, antigen, FVIII)
- Risk assessment before surgery/pregnancy
Treatment: Mechanism-Based
- Hormonal therapy
- Tranexamic acid
- DDAVP / vWF concentrates
Core Message
- Treating bleeding alone: incomplete care
- Identifying cause: changing outcomes
Final Thought
Every unexplained bleeding in a woman deserves a hemostasis workup.
Because sometimes, ‘just a period’ is a missed diagnosis.”
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