Congenital Prothrombin Deficiency: A Rare Cause of Puberty Menorrhagia

During the transitioning through puberty, adolescents present with varied gynaecological issues, among which puberty menorrhagia is a significant complaint. The most common underlying cause of puberty menorrhagia is anovulation, other causes being endocrine dysfunction, PCOS and bleeding disorders. Congenital prothrombin deficiency is an extremely rare inherited coagulopathy, affecting one in two million of general population. Depending on the severity of deficiency they present with myriad bleeding tendencies, including epstaxis, soft tissue bleeds, GI hemorrhage, intracranial hemorrhage, menorrhagia, excessive post traumatic and post-surgical bleeding. Here, we present a very rare case of congenital prothrombin deficiency presenting primarily with puberty menorrhagia.