Just so you can't say that I only post things that back up my positions

[Guest]

J Thromb Thrombolysis. 2007 Jan 27; [Epub ahead of print]

Menorrhagia and minor bleeding symptoms in women on oral anticoagulation.Sjalander A, Friberg B, Svensson P, Stigendal L, Lethagen S.
Department of Internal Medicine, Sundsvall Hospital, Sundsvall, Sweden.

BACKGROUND: Oral anticoagulation (OA) is a common treatment with a known risk of fatal or major bleeding, but also minor bleeding symptoms and menorrhagia can cause substantial discomfort and necessitate medical or surgical interventions. The extent of these side effects is however not previously reported. The objective of this study is to assess the frequency of minor bleeding symptoms and menorrhagia attributed to OA treatment. METHODS: Ninety fertile women between 15 and 49 years-of-age on OA treatment completed an inquiry at the anticoagulation clinics of Malmo, Lund and Gothenburg, Sweden. RESULTS: The frequency of minor bleeding symptoms was significantly increased during OA treatment (P < 0.05) except for hematuria. The incidence of bleeding after tooth extraction (>3 h) increased from 3.0 to 45.2%, easy bruising 17.8-75.6%, epistaxis 11.1-23.6%, gingival bleeding 22.2-48.3% and hematuria 10.0-15.6% (Table 1). Hematemesis was reported in 5.6% prior to as compared to 14.4% during OA treatment, blood in the feces in 8.9 and 18.9%, respectively. Mean duration of menses increased from 5.6 to 6.1 days (P < 0.01) and reported menorrhagia from 44.2 to 70.8% (P < 0.001). Eighteen percent were treated for menorrhagia before and 29.9% during OA treatment (P < 0.01). CONCLUSIONS: OA treatment is known to confer increased risk of fatal or major bleeding. This study shows that fertile women on OA also experience significantly increased minor bleeding symptoms including menorrhagia that may considerably impair quality of life.

 

[Mary]

As one of the female vr members who was vocal in my complaints about menstrual bleeding while on anticoagulants, I thank you for posting the results of this study.

 

[aussigal]

I think we girls should all be forewarned about this possible side-effect. My surgeon discussed this with me.

I personally would like to recommend hysterectomies before OHS to ladies who will be on ACT for life.

 

[Bridgette]

I just wanted to say I couldn't agree more!

I had a hysterectomy 6 months before my valve replacement as I knew there was a pretty good chance I would be getting a mechanical valve. No way was I going to be on Warfarin and still be having monthly periods - they were VERY HEAVY anyway, and I could not have lived with them being even worse due to the Warfarin.
In saying that, I was lucky to have completed my family.....what a dilemma if a woman still wanted to have more children and have to face this issue?

Bridgette

 

[Mary]

I think we girls should all be forewarned about this possible side-effect. My surgeon discussed this with me.

I personally would like to recommend hysterectomies before OHS to ladies who will be on ACT for life.

Ton,
Maybe we should also give a "heads-up" pre-surgery to the ladies that they will undoubtedly experience a menstrual cycle while in the hospital. That seems to be a common experience, but one no one mentions unless asked. I wonder if it has to do with the lovenox shots that are given?

 

[Karlynn]

I don't know that I'd recommend hysterctomies for all. What I would recommend is that women look into is uterine ablation.

I never had problems with my periods. Now these last few years as I approach menopause, I do have a day that is really heavy. But so far nothing I can't put up with. I do know that some women have significant issue with menstrual flow, so I feel fortunate.

 

[aussigal]

Mary...Definately...we have mentioned this a few times in the past, but I think we need to keep mentioning it. I had the weird experience of being unconscious for the first 4 days and the nurse told me they "took care of it" for me...I didnt know whether to be embarrassed or what!...

Karlynn...yeah...I was going to mention Uterine Ablation as thats what I had done (with fabulous results) but I wasnt sure how many would know what it was ('spose there's always Google to answer that )

 

[Guest]

I currently have a patient who had a water ablation and has been bleeding for a month.

 

[twinmaker]

I was also looking into a hysterectomy or a uterine ablation, but thank goodness menopause finally caught up with me. I thought it would never get here. I'm 54 and haven't had a period for 6 months. It's heaven! (sorry to be so graphic!). LINDA

 

[Karlynn]

I'm 54 and haven't had a period for 6 months. It's heaven! (sorry to be so graphic!). LINDA

Stop trying to make me jealous!

Al - I'm wondering what is going on with your patient. If you ever get any info- could you let us know. Uterine ablation is something I have been considering.

 

[twinmaker]

Karlynn, sorry to make you jealous, but I was really beginning to wonder if I would ever go into menopause. My sister and mother went into it in their latter forties, and here I was at 54 still having periods when I least expected them. I mean, I started my periods at 11 years of age and stopped at 54. And to have been on Coumadin for 25 of those 43 years. (I think my math is right.) Enough is enough! LINDA

 

[sue943]

My surgeon took me of HRT the day before my OHS so I have not had another period, and I agree with twinmaker, sheer bliss.

 

[Karlynn]

My surgeon took me of HRT the day before my OHS so I have not had another period, and I agree with twinmaker, sheer bliss.

Oh just great! Another "blissful person" that has to just rub it in.

 

[Granbonny]

I am sure..I just posted this on another thread.. But, I had my last period on the day I turned age 50...The best present that day...Just stopped. no more periods.. ....No menopause....Age 66 now..Still have all my woman things. minus one ovary...PCP even told me..your pap smears are normal...no reason to do them for another year or so.. ......Bonnie

 

[aussigal]

I had my Ablation about 6 years ago, way before I even knew what my future held in the way of OHS. It was the best result for me back then. I had no problems afterwards...I had a regular Ablation where they zap/burn the uterine lining...never heard of a water version, poor gal to be in that predicament.

 

[Karlynn]

My OB/GYN says he prefers the method that you had Ton. I don't know why, so I'm curious as to why Al's patient is still having bleeding with the water method.

 

[Lisa in Katy]

Al, I can't help but say "we told you so!"

I had signficant menstrual bleeding leading to anemia for two years after my OHS until my partial hysterectomy (I still have ovaries so still have hormones) - best surgery I ever had, with NO complications! My doctor didn't recommend ablation because many women who have that procedure still have bleeding, which with OA, could continue for long periods of time. My friend had ablation and still has light periods each month. I guess this is what is happening with Al's patient.