We must counsel about the possibility of abnormal uterine bleeding starting, or worsening when commencing oral anticoagulation.  

Check out the Prescriber update – December 2023 edition – https://www.medsafe.govt.nz/profs/PUArticles/PDF/Prescriber-Update-44-No.4-December-2023.pdf

Check out the paper mentioned

de Jong CMM, Blondon M, Ay C, Buchmuller A, Beyer-Westendorf J, Biechele J, Bertoletti L, Colombo G, Donadini MP, Hendriks SV, Jara-Palomares L, Nopp S, Ruiz-Artacho P, Stephan P, Tromeur C, Vanassche T, Westerweel PE, Klok FA. Incidence and impact of anticoagulation-associated abnormal menstrual bleeding in women after venous thromboembolism. Blood. 2022 Oct 20;140(16):1764-1773. doi: 10.1182/blood.2022017101. PMID: 35925686.

https://pubmed.ncbi.nlm.nih.gov/35925686/

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