{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T05:25:43Z","timestamp":1771046743351,"version":"3.50.1"},"reference-count":16,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,2,25]],"date-time":"2019-02-25T00:00:00Z","timestamp":1551052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Patients with generalized joint hypermobility (JHM) may experience excessive bruising\/bleeding, with heavy menstrual bleeding (HMB) commonly reported. We performed a retrospective review of 30 adolescents seen in a Young Women's Hematology Clinic with both HMB and JHM. We found that (1) a significant delay (mean 36 months, range 5\u201372) occurred between menarche and referral to specialty care, (2) HMB had moderate to severe impact on school and physical activities in 60% of patients, and (3) most patients (68%) required escalation of their initial therapy. We suggest providers consider JHM as a risk factor for a more complex clinical course.<\/jats:p>","DOI":"10.1002\/pbc.27675","type":"journal-article","created":{"date-parts":[[2019,2,26]],"date-time":"2019-02-26T06:41:14Z","timestamp":1551163274000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Characterizing adolescents with heavy menstrual bleeding and generalized joint hypermobility"],"prefix":"10.1002","volume":"66","author":[{"given":"Nicole E.","family":"Kendel","sequence":"first","affiliation":[{"name":"Pediatric Residency Program Nationwide Children's Hospital\/The Ohio State University Ohio  Columbus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fareeda W.","family":"Haamid","sequence":"additional","affiliation":[{"name":"Division of Adolescent Medicine Nationwide Children's Hospital\/The Ohio State University Ohio  Columbus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myra","family":"Christian\u2010Rancy","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology\/Oncology Nationwide Children's Hospital\/The Ohio State University Ohio  Columbus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8855-9746","authenticated-orcid":false,"given":"Sarah H.","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology\/Oncology Nationwide Children's Hospital\/The Ohio State University Ohio  Columbus"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,2,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2013.03.003"},{"key":"e_1_2_7_3_1","doi-asserted-by":"crossref","unstructured":"The Ehlers\u2010Danlos Society.Assessing joint hypermobility.https:\/\/www.ehlers-danlos.com\/assessing-joint-hypermobility\/. 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