September 7, 2000
Contact:  Jennifer Day, (313) 577-1058, jday@med.wayne.edu

Women’s bleeding disorders may be misdiagnosed, WSU professor says

Women who suffer from excessive menstrual bleeding may have undiagnosed inherited blood disorders, according to Jeanne Lusher, Wayne State University School of Medicine distinguished professor of pediatric hematology-oncology.

In several recently published studies of reproductive-aged women with excessive menstrual bleeding of unknown cause, 10 percent to 25 percent were found to have an inherited bleeding disorder. Most often, the women had von Willebrand disease, an easily treated disorder in which platelets are unable to attach to the site of an injury to stop bleeding.

“The real message here is to get women and their primary-care physicians to realize that they might have bleeding problems,” said Dr. Lusher, who recently presented a plenary address on this subject at the Congress of the World Federation on Hemophilia. “The failure to recognize such a disorder can have serious implications for her health as well as for her self-esteem. Many of these young women avoid going to school, work or social functions during their menses, for fear of embarrassing flooding.”

Quite often women don’t know to ask their doctors to test them for blood disorders because they don’t realize their periods are abnormally heavy. Women tend not to discuss such matters with anyone other than perhaps their mothers or sisters, who may consider it normal because they also suffer from the same undiagnosed conditions. If they do ask their gynecologists or primary-care physicians, often the doctor will focus only on uterine causes without even thinking of an underlying disorder, Dr. Lusher said.

Although there are several blood disorders that may cause excessive menstrual bleeding, or menorrhagia, the most common cause is von Willebrand disease. Von Willebrand disease affects at least 1 percent of the population, but may be responsible for as much as 20 percent of cases of menorrhagia.

It is characterized by mucous membrane bleeding, including that of the nose and gums. It can be treated effectively with an intranasal spray. If a woman suspects she may have von Willebrand disease or some other inherited blood disease, she should ask her doctor to obtain appropriate blood tests.