Brief Answer: Be cam and monitor up to next menstruation. Detailed Answer: Hi and thank you so much for this query. I am so sorry to hear about the changes you have noticed in your menses this month. Also, sorry about the PE's that have mandated treatment with ribaroxaban. From the information you have provided heavy bright red bleeding during menses is truly not the standard. The only reason why I may stay indifferent to that is because you are taking a drug that can actually cause your menses to flow more than expected. Black and scanty menses, though not common is not always a disease. Menstrual flow can change from one time to time. However, if it is accompanied with other symptoms like pain or symptoms of pregnancy, then we need to investigate deeply. if it is all about the colour and volume, monitoring for a few more cycles before aggressively investigating is the way to go. I will suggest that you treat them as normal menses and only seek medical advice if anything abnormal should be associated with this(severe pains, more than the normal bleeding duration or fear of pregnancy). I hope this addresses your query fully and provides ample information for you to act on. Thank you for using our services and please fee free to request for more information if need be. I wish you well. Dr. Ditah, MD

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