von Willebrand disease and other inherited bleeding disorders in women with diagnosed menorrhagia

Objective: To estimate the prevalence of von Willebrand disease and other b leeding disorders in women with and without diagnosed menorrhagia. Methods: Women with menorrhagia were identified among members of a health m aintenance organization in the southeastern United States through a compute r search for appropriate international Classification of Diseases, 9th Revi sion codes. A random sample of members with no such code was selected as co ntrols. The study included 121 women with menorrhagia and 123 controls. Sub jects were interviewed in person, and blood was drawn for coagulation testi ng. Laboratory results for menorrhagia patients were compared with those in controls using race and blood type specific ranges developed from the cont rol group. A test was considered abnormal if it exceeded two standard devia tions below the control mean. Results: Bleeding disorders (von Willebrand disease, factor deficiency, or a platelet abnormality) were diagnosed in 10.7% of menorrhagia patients and 3.2% of controls (P = .02). von Willebrand disease was present in eight me norrhagia patients (6.6%) and in one control (0.8%) (P = .02); separate ana lyses by race revealed a von Willebrand disease prevalence of 15.9% among w hite and 1.4% among black menorrhagia patients (P = .01). Women with bleedi ng disorders did not differ significantly from controls in other symptoms o f bleeding. Conclusion: The prevalence of inherited bleeding disorders among white wome n with menorrhagia was substantial, consistent with European data published recently. For unknown reasons, the prevalence of von Willebrand disease wa s lower among black women. These findings indicate the importance of consid ering inherited bleeding disorders as a cause of menorrhagia. (C) 2001 by T he American College of Obstetricians and Gynecologists.