About Your Low Platelet Count

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

About Platelets

Platelets are blood cell fragments (pieces) 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 in each microliter (mcL) of blood. Your platelet count is measured during a complete blood count (CBC). The lower your platelet count, the higher your risk of bleeding.

Signs of Bleeding

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

• Unusual bruising.

• A pale red rash on your chest, abdomen (belly), arms, or legs.

• Heavy bleeding during your period.

• Broken blood vessels in the white of your eye (sclera).

• Gum or mucous membrane bleeding or leaking.

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 healthcare provider has told you that you have a low platelet count, try to avoid getting hurt.

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

Self-care

• Do not use sharp objects, such as straightedge razors, scissors, and nail clippers. You can use an electric razor.
• Do not get:
  • Manicures or pedicures.
  • Waxing.
  • Electrolysis (hair removal treatment).
  • Tattoos.
• Try not to blow your nose. Blow your nose gently if you need to.
• Do not use:

  • Rectal suppositories (medication that’s inserted through your anus).

  • Rectal thermometers.

  • Enemas (liquid put into your anus to cause a bowel movement).

  • Tampons. Use a sanitary pad instead.

• If you’re straining to have bowel movements (poop), talk with your healthcare provider about using stool softeners or laxatives.

Dental care

• Use a soft-bristle toothbrush.

• Do not have your teeth cleaned. Talk with your healthcare provider before you have any dental work.

Activities

• Wear protective gloves when gardening, cooking, and doing home repairs.
• Avoid activities that may hurt you, such as:
  • Contact sports.
  • Climbing ladders.
  • Strenuous exercise.
  • Bicycling.
  • Weight lifting.
• During sexual activity:
  • Use lubrication, if needed.
  • Avoid anal sex.
  • Avoid strong thrusting.

Medications

Certain medications are known to slow down platelet function and may cause bleeding. Avoid taking them if you have a low platelet count.

• Do not 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, Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), or Vitamin E (www.mskcc.org/pe/common_meds), or search for it on www.mskcc.org/pe.

What to Do If You’re Bleeding

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

1. Do not panic. Your body has a lot of blood. Your blood volume is based on your body weight. This is about 80 mL (almost 3 ounces) of blood for each kilogram (2.2 pounds) of body weight.

2. Write down the exact time your bleeding started.

3. Apply direct, constant pressure on the area for at least 10 to 15 minutes. If you have a nosebleed, apply ice and pressure over the bridge of your nose.

If bleeding continues after applying pressure, call your MSK healthcare provider. Go to your local emergency room if you cannot control the bleeding and:

• You cannot reach your healthcare provider.

• You live too far from MSK.

When to Call Your Healthcare Provider

Call your healthcare provider right away if you have any of the following:

• Black bowel movements (stool), blood in your bowel movements, or bleeding from your rectum.

• Blood in your urine.

• Headaches that don’t get better after you take acetaminophen.

• Blurred vision.

• Dizziness (feeling like you’re going to faint).

• Any bleeding that doesn’t get better in 15 minutes. This includes coughing up blood, vomiting (throwing up) blood, or nose bleeds.

Treatment

If your platelet count is 10,000 mcL or less, you may need 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.

• You have a lot of bleeding.

• You had or will have an invasive procedure (going into the body through a cut, slit, or puncture).

• You have signs of other disorders. Other disorders include Vitamin K deficiency and liver function failure.

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