Management of heavy menstrual bleeding in women on long term anticoagulants


  • L. Ashwini Vishalakshi Department of Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India



HMB, Anticoagulation, Thromboembolism


Women taking anticoagulants for therapeutic or prophylactic indications has been on the raise since the past few years. Heavy menstrual bleeding (HMB) due to anticoagulant use is also on the raise. Hence, we need to explore various treatment strategies which can reduce or stop the HMB. Various methods that have been tried like reducing the dose of anticoagulants, changing over to a different anticoagulant with lower incidence of HMB, addition of tranexamic acid or progesterone, use of combined oestrogens and progesterone contraceptives etc. In cases of intractable bleeding not controlled with medical measures surgical options like intrauterine balloon tamponade, endometrial ablation or uterine artery embolization may be tried. The last resort is hysterectomy. This review discusses about the various options available that can used in treating women with HMB who are on anticoagulation.


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