4.2 Review

Menstruation, anticoagulation, and contraception: VTE and uterine bleeding

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Summary: The study investigated rates of heavy menstrual bleeding (HMB) in users of rivaroxaban and apixaban, finding an association between rivaroxaban use and the need for medical or surgical intervention for HMB. Most women did not have a documented menstrual history, indicating that many providers do not inquire about menstrual bleeding when initiating anticoagulant therapy. Menstruating women, especially those with a history of HMB, may be at increased risk for HMB requiring medical treatment depending on the type of OAC used.

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