Brief Answer:
Hi I would advice a coagulation study and a dermatology consult

Detailed Answer:
Hi,
I did review your concern mam.
Livial is trade name for Tibolone which is used by many for hot flashes and is a good drug for that. However, Livial is not commonly known to cause bruises. It can cause skin lesions that look like bruise like chloasma or erythema multiforme.
I would recommend you to consult a dermatologist and get the skin lesion evaluated. sometimes they look like bruises and are actually something else and hence takes time to go away even with hirudoid assistance.

If you can please upload the pics here for me so that I can see and comment on the skin lesion and provide my opinion. If they feel like bruise then I would advice a coagulation profile in form of PT and PTTK along with platelet count first of all.

So all in all, My recommendations would be-
1) Upload the skin lesion pics here and/or consult a dermatologist and get the lesion evaluated and confirm that these are bruises only(lesions due to extravasation of blood/hematomas).
2) A coagulation profile in terms of platelet count, PT and PTTK(APTT).

Once we know exactly what it is we can treat it accordingly.

I hope this helps
Wish you all the best,
waiting for your reply
Let me know if you have any more questions or concerns for me.
Sincerely,
Dr Parth Desai

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Brief Answer:
You can try the following food stuffs to prevent and heal bruises faster

Detailed Answer:
Hello Mam,
Thank you for your reply query.
Since, these lesions come only after contact and hurt a bit they are most probably bruising.
If this bruising is located only on your legs and arms then you do not need to worry much and there is no need to be emergently evaluated. A concomitant bruise on face and trunk and large bruises as well as family history of bruises should lead to further investigations.

Easy bruising with normal coagulation profile can be due to defect in function of platelets or defect in vessel wall. This can be due to genetic problems, acquired nutritional deficiencies or due to medications.

Tibolone generally does not cause easy bruising, however there are few reports of it being associated with easy bruising and it can be theoretical possible as it is a steroidal drug and steroids make the capillaries fragile.

In case you want to further investigate the cause of your bleeding, I would recommend you to consult a hematologist expert in coagulation pathology and get some tests done like vonwillibrand factor assay and platelet function tests.However they are not urgently needed if your lesions are just on arms and legs.

Few of the foods that can prevent bleeding or make it heal faster according to proven medical literature are-

1) Foods rich in Vitamin K such as dark leafy vegetables especially spinach. It helps in strengthening our coagulation system.

2) Foods rich in Vitamin C such as oranges, lemons, Kiwi and other citrus fruits as well as tomatoes and brussel sprouts as it helps in strengthening our vessel wall. It is an intergral part of Collagen protein that forms our vessel wall.

3) Pineapple also contain an active substance Bromelain that helps in reducing inflammation and bruises. Even separate bromelain extract is available in market.

4) Food rich in proteins can also be taken as they are also required to maintain the supporting structure for our vessels.

I would recommend to cut down a bit on red meat as red meat has been recently associated with colon cancer. Also what you can do is eat high fiber diet like oats and green leafy vegetables and fruits with red meat to support its proper digestion and passage through colon.

I hope this helps.
Let me know if you have any more questions or concerns. I will try my best to answer it to the best of my abilities mam.
Wish you all the best.
Sincerely,
Dr Parth Desai

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