New clinic addresses increase in bleeding disorders among young women


Excessive menstrual bleeding can be an inconvenience and source of embarrassment for adolescent girls. Sometimes it even leads to hospitalization and transfusions and may be a symptom of an undiagnosed bleeding disorder.

Physicians from Akron Children's Hospital's division of Adolescent Medicine and its Showers Family Center for Childhood Cancer & Blood Disorders are collaborating to offer a Young Women's Bleeding Disorder Clinic for girls and women from the onset of menstruation to 25 years of age.

"It's a lot more common than you would think so we want to bring together a multidisciplinary team to support these girls and young women," said Nneka Holder, MD, an adolescent medicine specialist.

Dr. Holder is teaming up with hematologists Erin Cockrell, DO, and Stephanie Savelli, MD, to offer the clinics on the first Thursday of the month, beginning Oct. 7.

The clinics will help the physicians sort out regular – albeit heavy – menstrual bleeding from a bleeding or platelet disorder. The most common is von Willebrand's disease, which is caused by a defect or deficiency of a blood clotting protein. It is estimated to occur in 1 to 2 percent of the population. It is a genetic disease which can be inherited from either parent or both parents, and can range in severity depending on the inheritance pattern. It is diagnosed with a blood test.

"Oftentimes, a girl's first menstrual period is our first clue that she may have von Willebrand's disease or another bleeding disorder," said Dr. Cockrell. "It's also common to hear the girl's mother say she has always had heavy periods too."

Akron Children's has been diagnosing more girls and young women with bleeding disorders. From 2000 to 2004, the hospital recorded 44 newly-diagnosed bleeding disorders in female patients from ages 12 to 25. That number almost doubled from 2005 to 2009 with 85 new diagnoses.

"Excessive menstrual bleeding is not something to take lightly," said Dr. Cockrell. "I have had patients become so weak they require hospitalization and transfusions. It can take a toll psychologically too. These girls and young women suffer embarrassment, miss frequent school days, and may begin limiting their activities."

Once diagnosed, von Willebrand's disease mostly can be treated with a nose spray administered on the first two days of the menstrual cycle. Occasionally other treatments may be used and birth control pills may also be prescribed to help regulate periods.

"Adolescent girls should feel comfortable talking to their pediatrician or primary care physician about their menstrual periods," said Dr. Holder. "Because it is so important to a woman's health and well being, some members of the medical community refer to the menstrual period as the fifth vital sign."

For more information about Akron Children's Young Women's Bleeding Disorder Clinic, call 330-543-8580.

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