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For iron deficiency anemia due to heavy menstrual bleeding, what is your preferred method of controlling heavy menses?

Do you recommend IUDs vs OCPs for managing menses? Do you always add tranexamic acid or other antifibrinolytics as first-line therapy?
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Do you typically offer antifibrinolytics upfront for heavy menstrual bleeding?

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3 Answers
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Hematology · The Mass General Porphyria Center
Answered on

I definitely loop in my GYN friends for this one! According to ACOG: "Heavy menstrual bleeding is defined as excessive menstrual blood loss that interferes with a woman's physical, social, emotional, or material quality of life." The consequences of HMB are substantial and multifaceted, and, as we f...

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Hematology · Gundersen Health
Answered on

Thanks for this important question. Too often, we see women in hematology clinics who have had terrible bleeding for years, and the menorrhagia has not been addressed, only the iron deficiency. From a hematology perspective, I make sure to do an ISTH bleeding score assessment to see if she needs to ...

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Primary Care · Montefiore Wakefield Ambulatory Care Center
Answered on

When heavy menstrual bleeding (HMB) causes iron deficiency anemia (IDA) or interferes with quality of life, it is advised to offer treatment. There are hormonal, nonhormonal, and surgical options, depending on the etiology of HMB.

The main way to address HMB causing IDA is to control menses via horm...

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