Overview
This study aims to investigate uterine bleeding during menstruation in women taking antithrombotic medications after cardiac surgery. It will evaluate the proportion of patients with abnormal bleeding, such as heavy menstrual bleeding and prolonged menstrual periods, identify associated risk factors, and determine the characteristics of high-risk female patients.
Eligibility
Inclusion Criteria:
- Female patients aged 18 to 49 years.
- Underwent cardiovascular surgery at our institution (e.g., coronary artery bypass grafting, heart valve repair/replacement, aortic surgery, congenital heart disease correction, heart transplantation).
- Absence of heavy menstrual bleeding (HMB) or prolonged menstrual bleeding (\> 8 days) during the two consecutive menstrual cycles immediately prior to surgery.
- Experienced at least one complete menstrual bleeding episode within the predefined postoperative follow-up window.
- Receiving postoperative oral antiplatelet therapy (e.g., aspirin, clopidogrel) and/or oral anticoagulant therapy (e.g., rivaroxaban, warfarin).
- Concurrent use or non-use of estrogen/progestin modulation therapy is permitted.
Exclusion Criteria:
- Previous diagnosis of congenital bleeding or coagulation disorders (e.g., hemophilia, von Willebrand disease, congenital coagulation factor deficiencies, congenital thromboembolic diseases).
- History of endometrial ablation/resection, bilateral oophorectomy, or hysterectomy.
- Current diagnosis of gynecological malignancies requiring chemotherapy, radiotherapy, or targeted therapy.
- Pregnant or within 3 months postpartum prior to surgery or during the follow-up period.
- Currently undergoing or planning to undergo in vitro fertilization (IVF) treatment.
- Presence of psychiatric disorders, severe cognitive impairment, or other conditions precluding the effective completion of study assessments.
- Failure or inability to provide written informed consent.
