HWN Suggests

CRACKCast E034 – Vaginal Bleeding

Treatment:

• NSAIDS
• Tranexamic acid 1 g TID x 7 days
• Premarin (conjugated ESTROGEN) – IV or IM 25 mg and q 6 hrs prn
• IF bleeding continues insert foley catheter into cervical os and inflate to tamponade the bleeding Leave in place for 12-24 hrs
• Birth control pill with at least 35 mcg of estradiol BID until bleeding stops or up to 7 days

Contraindications to estrogen use:

• Thromboembolic events / strokes
• Estrogen dependent
• Active liver disease
• Pregnancy

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