Abnormal Uterine Bleeding in a Patient with Alcoholic Liver Disease View PDF

*Megan Kalata
Department Of Obstetrics And Gynecology, Creighton University, Creighton University, Creighton University, Nebraska, United States

*Corresponding Author:
Megan Kalata
Department Of Obstetrics And Gynecology, Creighton University, Creighton University, Creighton University, Nebraska, United States
Email:megankalata@creighton.edu

Published on: 2023-05-17

Abstract

Background: Traditional medical therapies for the management of abnormal uterine bleeding cannot be used by patients with liver disease. Given that the incidence of liver disease is increasing among women in the United States, it is crucial to understand options for management among this high-risk population.
Case Presentation: This case presents a patient with acute-onset heavy vaginal bleeding in the setting of acutely decompensated alcoholic liver disease.
Outcomes: The patient was started on tranexamic acid for the management of her bleeding given her contraindication to typical medical management, such as oral contraceptives or IV estrogen.
Recommendations: In instances of acute vaginal bleeding for patients like the one presented here, tranexamic acid may be a safer, more appropriate option to bridge patients to the point where long-term management can be addressed for their underlying conditions.

Keywords

Uterine Bleeding; Alcoholic Liver Disease; Vaginal Bleeding; Estrogen; Oral Contraceptives; Tranexamic acid

Introduction

Women are becoming increasingly at risk for alcohol-related liver disease and its complications. Although liver disease still affects more men, younger women are driving the increase in deaths, a trend that has become amplified by the recent COVID-19 pandemic. Liver disease has the potential to impact the menstrual cycle through a variety of mechanisms, which is significant as approximately 4% of American women of reproductive age have severe alcohol use disorders [1]. Complications of substance use, such as coagulopathy, are more common in these instances and present an interesting management dilemma for women with acute vaginal bleeding, as evidenced by the following case.

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