The prevalence of bleeding disorders in women with proven endometriosis: results of a screening study.

ObjectiveTo establish the rate of bleeding disorders amongst women with confirmed endometriosis and clarify predictive features on history. MethodsEight-two women with confirmed diagnosis of endometriosis were recruited from a tertiary womens hospital. General bleeding tendency was evaluated with a modified internationally standardised questionnaire, and a bleeding score was calculated. Menstrual loss was evaluated by obtaining current and heaviest-ever menses profile using Pictorial Blood loss Assessment Chart(PBAC). Forty-one women satisfied criteria for a significant bleeding tendency and underwent coagulation tests including Prothrombin time(PT), activated partial thromboplastin time(aPTT), Platelet Function Analyser-100(PFA-100) and von Willebrand factor(vWF)/Factor VIII(FVIII) studies. ResultsThe prevalence of abnormal screening haemostasis tests for the population was 17.72% (95% CI 10.04-27.94) for all tests, 8.54%(95% CI 3.50-16.80) for vWF tests, and 12.99%(95% CI 6.41-22.59) for PFA-100. Receiver Operator Characteristic curve analysis demonstrated a very good performance of the bleeding score as a diagnostic test for haemostatic abnormalities for nulliparous women with endometriosis. Bleeding symptoms individually were not predictive. Logistic regression suggested the combination of mittleschmerz, cutaneous bleeding symptoms, heavy menstrual bleeding and prolonged bleeding from minor wounds as predictive for haemostatic abnormalities (p=0.0197). ConclusionThe prevalence of abnormal bleeding tests in women with endometriosis on preliminary testing was higher than the population rate of bleeding abnormalities and thus people with histologically proven endometriosis warrant a higher index of suspicion with respect to testing for mild bleeding disorders. Bleeding disorders in women with endometriosis