Change in Thrombin Generation Potential and Thromboelastography During the Menstrual Cycle

We propose that TG and TEG will be more sensitive than traditional coagulation assays to
detect physiologic variation in hemostasis, fibrinolysis, and platelet activation throughout
the menstrual cycle. We expect that TG and TEG will better discriminate patients with vWD
than traditional coagulation studies during the menstrual cycle. In this study we plan to
measure TG and TEG in healthy women and women with von Willebrand's disorder during four
phases of the menstrual cycle. We will compare specific measurements of endogenous thrombin
generation potential from the TG and fibrinolysis and platelet activation from the TEG with
standard measures of coagulation, fibrinolysis, and platelet activation markers during the
menstrual cycle.

Inclusion Criteria:

- Females of reproductive age with regular menstrual cycles and a diagnosis of von
Willebrand disease according to the International Society of Thrombosis and
Hemostasis diagnostic criteria.

Exclusion Criteria:

- Females who are pregnant, or have a history of endocrinopathy or hormone imbalance

- History of hysterectomy or bilateral oophorectomy

- History of ovarian or uterine cancer

- Use of intrauterine device

- Use of antifibrinolytic therapy, hemostatic agents, or anti-platelet agents.