Abstract
Premenopausal women taking anticoagulation therapy are at risk of developing hemorrhagic ovarian cysts. This paper presents 3 cases of acute hemoperitoneum, with resultant surgical menopause, secondary to cystic hemorrhage in premenopausal women with repaired congenital heart disease (CHD). Adults with CHD taking long-term anticoagulation should be considered candidates for ovulation suppression with hormone-based contraception. (Level of Difficulty: Intermediate.).