New report outlines practical strategies to improve hematological care for women

A new report in The Lancet Haematology, led by Cleveland Clinic hematologist Bethany Samuelson Bannow, M.D., outlines practical strategies to improve diagnosis, care and outcomes globally for women and girls with hematological conditions, such as bleeding disorders, heavy menstrual bleeding, postpartum hemorrhage, thrombosis and maternal hematologic complications.

The Commission on Global Female Health and Haematology highlights the need for earlier diagnosis, more consistent treatment, and stronger research and education for hematological conditions. Drawing on evidence from clinical care, research, public health and policy, the findings from the Lancet Haematology Commission were presented at the International Society on Thrombosis and Haemostasis (ISTH) 2026 Congress in Paris, France.

Improving hematological care for women of all ages represents one of the clearest opportunities to strengthen health outcomes globally. Our findings underscore a major but addressable gap in women's health worldwide. The tools already exist, and this paper offers a forward-looking roadmap to apply them more consistently and equitably."

Dr. Samuelson Bannow, lead author, director of Classical Hematology, Cleveland Clinic Cancer Institute

The commission found that women and girls face inequities in blood-related health, including higher rates of anemia, delayed diagnosis, undertreatment and complications from bleeding and clotting disorders, particularly in relation to menstruation, pregnancy and the postpartum period. The report also highlights that women remain underrepresented in clinical trials, while female-specific health issues are often overlooked in research, policy and care delivery.

One of the report's most significant calls to action is to reduce the striking delay in diagnosing bleeding disorders: women wait an average of 14 to 16 years for a diagnosis, compared with about two years for men.

Heavy menstrual bleeding emerged as a central issue in the report. Affecting up to one in three women, it is often the first sign of an inherited bleeding disorder, yet it is frequently dismissed or inadequately treated. The authors call for routine menstrual health assessment, broader use of bleeding assessment tools, and stronger referral pathways to support earlier recognition and care.

The commission set a key goal to reduce the average time from symptom onset to diagnosis for women and girls with bleeding disorders to less than 24 months by 2035. The authors note that this target is ambitious but achievable if screening recommendations are incorporated into major guidelines and supported by clinician education.

"The publication of this commission represents an important milestone for women's health and hematology," said ISTH President Pantep Angchaisuksiri, M.D. "Women experience unique challenges related to bleeding and clotting disorders throughout their lives, yet many aspects of their care remain underrecognized or understudied. This commission provides an important resource for clinicians, researchers, policymakers and advocates to improve outcomes globally."

The report calls for immediate action to close gender gaps in hematological health and ensure equitable, evidence-based care worldwide. Key recommendations include faster diagnosis of bleeding disorders; universal screening for heavy menstrual bleeding and iron deficiency; standardized postpartum hemorrhage protocols; and more personalized thrombosis care during pregnancy and the postpartum period.

The authors also call for updated clinical guidelines, greater inclusion of women in research, targeted education and prevention programs, and stronger investment in women's health.

"The evidence is clear that meaningful progress is possible," said Dr. Samuelson Bannow. "With coordinated action across clinical care, research and education, we can deliver more timely, effective and equitable hematology care for women and girls around the world."