Why Focus on Blood Disorders in Women and Girls+?
While blood disorders affect both men and women, there are serious added consequences for women and girls+ due to the gynecologic challenges encountered during the menstrual cycle and throughout the reproductive life stages such as pregnancy, childbirth, and menopause.
|Life stage||Unique Issues for Women and Girls with Blood Disorders|
|Adolescence||Anticipation of menses|
If bleeding disorder, anticoagulation or thrombocytopenia:
– menorrhagia/heavy menstrual bleeding (HMB)
– hemorrhagic ovarian cysts
– possibly endometriosis
Risks and benefits of hormonal contraception
|Pre-conception||Genetic counseling for inherited bleeding disorders|
Risks to the mother of a pregnancy
Risks to the unborn baby associated with pregnancy
|Pregnancy||↓ risk of bleeding|
↑ risk of thrombosis
↓ platelet count
↑ frequency of sickle cell crises
Exacerbation of endothelial dysfunction with preeclampsia
|Childbirth||Risks of regional anesthesia for women with bleeding disorders, thrombocytopenia, or on anticoagulation|
|Postpartum||Risks of delayed hemorrhage in women with bleeding disorders|
Risks of thrombosis
|Perimenopause||Management of bleeding due to fibroids, polyps, and endometrial hyperplasia|
Risks and benefits of hormone replacement
Prophylaxis for either bleeding or clotting around procedures
The treatment and management of blood disorders present unique issues for women and girls. The delay in and/or failure to diagnose and treat blood disorders in women and girls are major public health problems. These result in significant morbidity, reduced quality of life, days lost from work and school, unnecessary invasive procedures, and high healthcare costs.