Background: Menorrhagia is a well-known complication of factor V deficiency.
Case: A 13-year-old girl with factor V deficiency presented with acute hemorrhage on day 4 of menses. Laboratory assessment revealed a hemoglobin of 36 g/L. The ultrasound appearance of a large loculated cystic mass was consistent with substantial intraperitoneal bleeding. Stabilization with blood products was followed by GnRH agonist therapy. Medical management was instituted effectively. Continued compliance with medication is essential to prevent recurrences.
Conclusion: Factor V deficiency is rare. Coagulation disorders of this nature pose a challenge to gynecologists involved in patient management at the time of menses.