Glanzmann Thrombasthenia (GT) is a rare bleeding disorder causing life-threatening bleeding at menarche in the adolescent female. We describe a 12-year-old menarchial female with persistent vaginal bleeding despite multiple treatment modalities including aminocaproic acid, recombinant factor VIIa (rFVIIa), intravenous estrogen, and gonadotropin receptor hormone agonists. Although the standard treatment of bleeding in patients with GT is primarily rFVIIa, new-onset menstrual bleeding in conjunction with an immature hypothalamus-pituitary-ovarian axis often requires expanding treatment to include multiple drug modalities. In our case, a two-step approach was necessary. First, targeting the cessation of menses. Secondly, optimizing long-term control of heavy menstrual bleeding.