Evaluation of Von Willebrand Disease in Women with Menorrhagia: Insights from a Cohort Study

This study aimed to evaluate the prevalence of von Willebrand disease (VWD) among women presenting with menorrhagia and to assess the diagnostic utility of the VWD simple screening tool. A prospective cohort study was conducted involving 70 women, aged 18–48 years, who presented to gynecology clinics with complaints of menorrhagia. Patients were administered an 8-question screening tool, routine tests and underwent further testing for von Willebrand factor antigen (VWF:Ag) and ristocetin cofactor activity (VWF:RCo). Hematologic and coagulation parameters, including hemoglobin, ferritin, activated partial thromboplastin time and prothrombin time were compared between the groups. Of the 70 patients, 22 (31%) were prediagnosed with VWD based on low VWF:Ag and VWF:RCo levels. The VWD group had a higher body mass index (31.19±3.74 vs. 28.20±5.36 kg/m², p<0.05), higher parity (4 vs. 3, p<0.05), and slightly elevated activated partial thromboplastin time levels (26.9 vs. 25.5 seconds, p<0.05) compared to the control group. Hemoglobin, ferritin, and other hematologic parameters were similar between the groups. Using the method applied in this study, 31% of patients with menorrhagia were suspected to have von Willebrand disease, a higher prevalence than reported in other studies. While the VWD simple screening tool was effective in identifying patients with menorrhagia, it fell short in accurately distinguishing those with VWD. Larger prospective studies are needed to enhance the diagnosis of VWD in menorrhagia patients and to better determine its true prevalence.