Thrombocytopenia due to Menorrhagia?

"Sir, I want to inform you about this patient" my Registrar said in the outpatient clinic. "What is it?" I asked. "She has menorrhagia for the last 3 cycles. Her pelvic findings are normal. Her hemoglobin is 5.2 g%, and platelet count is 35000/cmm." "So what do you think?" I asked her. "I think her hemoglobin and platelets are low because she has been bleeding." I was aghast. "Low hemoglobin is understandable if she is bleeding and does not have iron and folic acid replacements" I said, "but why platelet count should be low?" "Because the platelets are used up in the bleeding" she explained. "Do you think it is the other way round?" I asked. "Could she be having menorrhagia because she has a low platelet count due to whatever cause?" "Yes, I think that is the way it is" she agreed. I wonder what she has learned in last 2.5 years of residency, and what she will do in her MS examination after six months. Checking bleeding time, clotting time, and platelet count is a part of the investigations of every abnormal and excessive uterine bleeding in our unit. Why she would keep doing it and still not understand it is beyond me. I dared not ask her that question, because I could not stand the usual answer: "Sorry sir" with a semi-negative shake of the head.