Menorrhagia

doi:10.1136/bmj.322.7288.732

BMJ 2001;322:732 ( 24 March )

Letters

Menorrhagia

Underlying bleeding disorders need to be ruled out

Sexual history needs to be taken

Ten minutes may not be enough

Underlying bleeding disorders need to be ruled out

The first 150 words of the full text of this article appear below.

EDITOR $---$ We read with interest the first in your series of articles on common problems in primary care, on the topic of managementof menorrhagia.¹ We would, however, like to draw attentionto one important aspect that was overlooked, which we believedeserves widerrecognition.

Menorrhagia may be a manifestation of an underlying inherited disorder of coagulation. Such disorders are by no means rare.A recent British study found that as many of 17% of women withmenorrhagia and no underlying pelvic disease had an inheritedbleeding disorder, the most common of which was von Willebrand'sdisorder.² An earlier study from Sweden also found the prevalenceof von Willebrand's disorder among women with menorrhagia to be20%.³ The history in the initial consultation should thereforeinclude specific questions to elicit features suggestive of anunderlying bleeding disorder. These include a history of menorrhagiasince menarche, recurrent epistaxis, bleeding after . . . [Full text of this article]