Low Platelet Count

This information explains what platelets are and what to do when your platelet count is low. It also describes common signs of bleeding and explains what to do when you’re bleeding.

About Platelets

Platelets are blood cells that help form clots and stop bleeding. They are made in your bone marrow, which is the soft, spongy center in most of your large bones.

A normal platelet count is 150,000 to 400,000 platelets per microliter (mcL) of blood. Your platelet count is measured during your routine blood test.

Signs of Bleeding

Call your doctor if you develop any signs of bleeding, such as:

• Unusual bruising
• A faint red rash on your chest, abdomen (belly), arms, or legs
• Vaginal spotting or heavy menstrual bleeding
• Broken blood vessels in the white of your eye (sclera)

How to Avoid Bleeding

Cancer and cancer treatments can lower your platelet counts. When your platelet counts are low, you’re at risk for bleeding. If your doctor has told you that you have a low platelet count, it’s very important to try to avoid getting hurt.

We have listed some general ways you can prevent bleeding. It’s also important to talk with your doctor or nurse about your lifestyle. They may suggest other things you can do to prevent bleeding while your platelet count is low.

Self-care

• Don’t use sharp objects, such as straightedge razors, scissors, and nail clippers. You can use an electric razor.
• Don’t get:
  • Manicures or pedicures
  • Waxing
  • Electrolysis
  • Tattoos
• Try not to blow your nose. If you need to blow your nose, do it gently.
• Don’t use:
  • Rectal suppositories
  • Rectal thermometers
  • Enemas
  • Tampons
• If you’re straining to have bowel movements, talk with your healthcare provider about using stool softeners or laxatives.

Dental care

• Use a soft-bristle toothbrush.
• Talk with your doctor before you have any dental work.

Activities

• Wear gloves when gardening, cooking, and doing home repairs.
• Avoid activities that may result in injury. This includes:
  • Contact sports
  • Climbing ladders
  • Strenuous exercise
  • Bicycling
  • Weight lifting
• During sexual activity:
  • Use lubrication, if needed
  • Avoid anal sex
  • Avoid strong thrusting

Medications

• Don’t take:
  • Aspirin or products that contain aspirin
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil^®, Motrin^®) and naproxen (Aleve^®)
  • Vitamin E
• For more information about aspirin and other NSAIDs, ask your nurse for the resource Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Medications (NSAIDs), or search for it on www.mskcc.org/pe

What to Do When You’re Bleeding

If you start bleeding at home, take the following steps:

1. Apply direct pressure on the area that’s bleeding. If you have a nosebleed, apply ice and pressure over the bridge of your nose.
2. After applying pressure, call your Memorial Sloan Kettering (MSK) doctor. If you can’t reach your doctor and you can’t control the bleeding, go to your local emergency room.

Call your doctor immediately if you have:

• Black bowel movements (stool), blood in your bowel movements, or bleeding from your rectum
• Blood in your urine
• Headaches that don’t get better
• Blurred vision
• Dizziness
• Any bleeding that doesn’t get better, including coughing up blood, vomiting blood, or nose bleeds.

Treatment

If your platelet count is 10,000 mcL or less, you may need to have a transfusion of platelets to raise your platelet count.

You may also need to have a transfusion if your platelet count is higher than 10,000 mcL and you’re having significant bleeding, an invasive procedure, or have signs of other disorders.

If you bleed a lot during your monthly period, talk with your doctor. You may need to start hormonal therapy with birth control pills to prevent your next period.