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 adolescent girls due to the gynecologic challenges encountered during the menstrual cycle and throughout the reproductive life stages such as, pregnancy, childbirth and menopause. 

Life stageUnique Issues for Women and Girls with Blood Disorders
Adolescence

Anticipation of menses

If bleeding disorder, anticoagulation or thrombocytopenia>
- menorrhagia
- 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

↓ hemoglobin

↑ 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

Source: With permission from Dr. Andra James. Chart from PowerPoint slides, Introduction to FWGBD, May 2010.

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 health care costs.