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Heavy Menstrual Bleeding and Bleeding Disorders in Adolescents: A Primer for the Primary Care Physician

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Benign Hematologic Disorders in Children

Abstract

Bleeding disorders constitute an important etiology of heavy menstrual bleeding in adolescents that require detailed history taking, careful planning of the laboratory evaluation, and specific management approaches. Physicians, including primary care and family practice providers, should work in coordination with a hematologist for the management of heavy menstrual bleeding in adolescents when the suspicion of a bleeding disorder is high. The two core aspects of hematology care in heavy menstrual bleeding focus on the management of iron deficiency or iron deficiency anemia and diagnostic evaluation of a bleeding disorder. School absenteeism and interruption in sports or social activities frequently occur in adolescents with heavy periods. A delay in the diagnosis of bleeding disorder interferes with a woman’s physical, social, emotional, and material quality of life. Given the consequences of HMB, healthcare providers should be able to evaluate an adolescent who presents with HMB competently. This chapter will highlight key aspects of the approach to the evaluation of bleeding disorders in adolescents with heavy menstrual bleeding.

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Abbreviations

ACOG:

American College of Obstetricians and Gynecologists

Ag:

Antigen

BAT:

Bleeding assessment tool

DDAVP:

Desmopressin

F:

Factor

HMB:

Heavy menstrual bleeding

ITP:

Immune thrombocytopenic purpura

FIGO:

International Federation of Gynecology and Obstetrics

IDA:

Iron deficiency anemia

OC:

Oral contraceptives

PTT:

Partial thromboplastin time

PBAC:

Pictorial blood assessment chart

PFA-100:

Platelet function assay-100

PFDs:

Platelet function disorders

PCOS:

Polycystic ovarian syndrome

PT:

Prothrombin time

QoL:

Quality of life

RBC:

Red blood cell

RCo:

Ristocetin cofactor activity

TIBC:

Total iron-binding capacity

VWD:

von Willebrand disease

VWF:

von Willebrand factor

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Authors and Affiliations

  1. Division of Pediatric Hematology-Oncology, The University of Texas Southwestern Medical Center, Dallas, TX, USA

    Rida Abid Hasan & Ayesha Zia

  2. Department(s) of Pediatrics, The University of Texas Southwestern Medical Center, Dallas, TX, USA

    Rida Abid Hasan & Ayesha Zia

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  1. Rida Abid Hasan
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  2. Ayesha Zia
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Correspondence to Ayesha Zia .

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Editors and Affiliations

  1. Department of Pediatrics, University of Texas Health Science Center, San Antonio, TX, USA

    Deepak M. Kamat

  2. Department of Pediatrics, Division of Hematology-Oncology, The University of Texas Health Science Center, San Antonio, TX, USA

    Melissa Frei-Jones

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Hasan, R.A., Zia, A. (2021). Heavy Menstrual Bleeding and Bleeding Disorders in Adolescents: A Primer for the Primary Care Physician. In: Kamat, D., Frei-Jones, M. (eds) Benign Hematologic Disorders in Children. Springer, Cham. https://doi.org/10.1007/978-3-030-49980-8_20

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  • DOI: https://doi.org/10.1007/978-3-030-49980-8_20

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