Bleeding disorders occur when components in the blood, called “factors,” are missing or do not work correctly. This hinders blood clotting and makes it harder for the body to stop bleeding. One widely recognized bleeding disorder, hemophilia, sometimes occurs in females; more often, however, females carry the gene that causes the disorder. The most common bleeding disorder among females is von Willebrand Disease (VWD). Up to 3 million Americans, half of whom are female, have VWD. Typical symptoms of VWD and other bleeding disorders for females include heavy menstrual periods, easy bruising, frequent nosebleeds, and prolonged bleeding after minor injuries, surgery, childbirth, or dental work. Of the approximately 12 percent of menstruating girls and women who have heavy menstrual bleeding (menorrhagia),1 13 percent may have an inherited bleeding disorder.2 Unfortunately, most of these disorders go undiagnosed.
The U.S. Department of Health and Human Service’s National Institutes of Health recently published guidelines about diagnosing, evaluating, and treating VWD. Diagnosing a bleeding disorder requires taking a personal medical history, a family medical history, and conducting special laboratory tests. Fortunately, many of these disorders can be treated, allowing affected women to live a normal life. The guidelines can be found at www.nhlbi.nih.gov/guidelines/vwd/.
Experts in diagnosing and treating bleeding disorders can be found throughout the United States and its jurisdictions at more than 130 federally-funded hemophilia treatment centers (HTC). HTC treat a wide range of bleeding disorders, primarily inherited bleeding and clotting disorders. From 1991 to 2007, the number of female HTC patients grew nearly 300 percent, from 2,365 to 9,041. To locate an HTC, visit http://www.cdc.gov/ncbddd/hemophilia/HTC.html. For more information about bleeding disorders, call the National Hemophilia Foundation at 1-800-42-HANDI or visit www.hemophilia.org.
1 Hallberg L, Hogdahl AM, Nilsson L, Rybo G. Menstrual
blood loss—a population study. Variation at different ages
and attempts to define normality. Acta Obstet Gynecol
Scand 1966; 45(3):320–351.↑
2 Shankar M, Lee CA, Sabin CA, Economides DL, Kadir RA., von Willebrand disease in women with menorrhagia: a systematic review BJOG. 2004 Jul;111(7):734-40.↑