ReviewHematology. American Society of Hematology. Education Program2020
Management of heavy menstrual bleeding on anticoagulation.
Review in Hematology. American Society of Hematology. Education Program, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Interdisciplinary management of gynecologic bleeding with anticoagulation: a recommended toolkit from the Foundation for Women and Girls with Blood Disorders+ Thrombosis Subcommittee.Journal of thrombosis and haemostasis : JTH · 2025Guideline
- Treatment Algorithm in Cancer-Associated Thrombosis: Updated Canadian Expert Consensus.Current oncology (Toronto, Ont.) · 2021Pooled it
- Critical uterine bleeding after miscarriage in a warfarin-anticoagulated patient with mechanical heart valve: a case report.Journal of medical case reports · 2026Article
- Sex Differences in Cancer-Associated Thrombosis.International journal of molecular sciences · 2026Review
- Phase-Based Management of Heavy Menstrual Bleeding in Women with Bleeding Disorders: From Acute Control to Long-Term Maintenance.International journal of women's health · 2026Review
- Anticoagulation in malignancy: the patient who bleeds and clots simultaneously.Hematology. American Society of Hematology. Education Program · 2025Review
- Sex differences in hepatic enzymes and transporters involved in pharmacokinetics.Liver research (Beijing, China) · 2025Review
- Patient-centered management of heavy menstrual bleeding while on anticoagulation: A survey study.European journal of obstetrics, gynecology, and reproductive biology · 2025Article
- Anticoagulation Management: Current Landscape and Future Trends.Journal of clinical medicine · 2025Review
- Iron Deficiency Anemia.Advances in experimental medicine and biology · 2025Review
- SDIMMMER: A Proposed Clinical Approach to Optimize Cellular Physiology in Regenerative Medicine.Life (Basel, Switzerland) · 2024Article
- Double bad luck: pulmonary embolism and vaginal bleeding - a case report.International journal of emergency medicine · 2024Article
- Direct oral anticoagulants in pediatric venous thromboembolism: Experience in specialized pediatric hemostasis centers in the United States.Research and practice in thrombosis and haemostasis · 2023Article
- Article
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Heavy menstrual bleeding (HMB) is a common complication of anticoagulation, affecting ∼70% of menstruating women receiving oral anticoagulants. The risk of HMB is lower with apixaban and/or dabigatran than with rivaroxaban. HMB can result in iron deficiency with or without anemia, increased need for medical interventions, decreased quality of life, and missed school/work. Mainstays of treatment include hormone therapies such as the levonorgestrel intrauterine system, subdermal implant, and other progesterone-based therapies, which can result in decreased blood loss and, in some cases, amenorrhea. Combined hormone therapies can be used while patients continue receiving anticoagulation and are also highly effective for decreasing menstrual blood loss. Rarely, procedure-based interventions such as endometrial ablation may be required. Patients should be evaluated for iron deficiency and anemia and offered supportive therapies as needed. Abbreviating the course of anticoagulation or skipping doses can increase the risk of recurrent venous thromboembolism by as much as fivefold, but switching oral anticoagulants may be considered. Awareness of HMB and careful history taking at each visit are crucial to avoid a missed diagnosis.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.