Heavy menstrual bleeding

Template

Heavy menstrual bleeding, follow-up

Tap a choice or type a Repertoire Line to see how the note changes. Defaults are what the template inserts on its own.

Try a Repertoire Line

Practice wording only: leave out patient details. Nothing typed here is saved or sent.

MonthChoose anyFirst line

StatusChoose oneFirst line

BleedingChoose one

StabilityChoose one

AnemiaChoose one

LabsChoose any

IronChoose one

Medication planChoose one

Tranexamic acidChoose any

Blood pressureChoose any

PainChoose any

Testing and referral statusChoose any

ReferralChoose one

DispositionChoose one

Follow-upChoose one

Counseling paragraphChoose oneParagraph

CounselingNot in the note with these choices

Discussed the need for emergency evaluation today. Caregiver expressed understanding and agreement with plan. Answered all questions.

Note when inserted as is

Heavy menstrual bleeding, follow-up
November 2026: Doing well.
• Bleeding improved
• Hemodynamically stable, without dizziness
• No medication change planned at this time
• Follow up in 3 months or sooner as needed

Heavy periods often settle as cycles mature, and treatment aims for manageable bleeding and healthy iron levels; it can take a few cycles to see the full effect. Recommended supportive care with motrin as needed on heavy days with an emphasis on taking any iron as directed and tracking bleeding days and pad or tampon changes. Return precautions given including soaking a pad or tampon every hour, dizziness or fainting, a racing heartbeat, bleeding that will not stop, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

What the sources cover

Bleeding improved; normal; unchanged; heavier
Anemia course
CBC and ferritin ordered; von Willebrand panel timing
Iron daily, every other day, switch, stop
Hormonal plan, continuous pills, dose increase
Tranexamic acid
Blood pressure on combined pills
Gynecology; hematology
Follow-up 3 months

Return precautions in the template

soaking a pad or tampon every hourdizziness or faintinga racing heartbeatbleeding that will not stop

Sources

RCH Melbourne: Adolescent heavy menstrual bleeding
Cribsiders show notes: #40 Heavy Menstrual Bleeding (December 8, 2021)

Template

Tap a choice or type a Repertoire Line to see how the note changes. Defaults are what the template inserts on its own.

Try a Repertoire Line

Practice wording only: leave out patient details. Nothing typed here is saved or sent.

StabilityChoose one

LabsChoose any

Likely causeChoose one

AnemiaChoose one

Bleeding historyChoose any

IronChoose any

PainChoose any

Hormonal treatmentChoose one

Nonhormonal treatmentChoose any

ReferralChoose any

DispositionChoose one

Follow-upChoose one

Counseling

Heavy periods are common in the first years after periods start and sometimes come from a bleeding disorder, which the plan above looks for. Recommended supportive care with an emphasis on iron-rich foods, tracking bleeding, and tylenol or motrin as needed for cramps. Return precautions given including soaking through pads or tampons quickly, dizziness or fainting, fast heartbeat, bleeding lasting longer than usual, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

CounselingNot in the note with these choices

Discussed the need for emergency evaluation today. Caregiver expressed understanding and agreement with plan. Answered all questions.

Note when inserted as is

Heavy menstrual bleeding
• Hemodynamically stable
• Labs: CBC and ferritin
• Screened for bleeding disorder symptoms, including nosebleeds, easy bruising, and family history
• Referred to gynecology
• Follow up after the lab results

Heavy periods are common in the first years after periods start and sometimes come from a bleeding disorder, which the plan above looks for. Recommended supportive care with an emphasis on iron-rich foods, tracking bleeding, and tylenol or motrin as needed for cramps. Return precautions given including soaking through pads or tampons quickly, dizziness or fainting, fast heartbeat, bleeding lasting longer than usual, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

What the sources cover

CBC, ferritin, TSH, pregnancy test (exclude pregnancy before treating)
Bleeding disorder screen; von Willebrand testing
Hormonal, continuous pills for anemia, TXA
Gynecology, hematology

Return precautions in the template

soaking through pads or tampons quicklydizziness or faintingfast heartbeatbleeding lasting longer than usual

Sources

Cribsiders show notes: #40 Heavy Menstrual Bleeding (December 8, 2021)
The Cribsiders #40: Heavy Menstrual Bleeding
The Cribsiders #64: von Willebrand Disease

Few formal guidelines cover this topic, so the template also leans on expert opinion.