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BLEEDING DISORDERS AND WOMEN
Bleeding Disorders and Women
Because of obstetric and gynecological issues in particular, women who are
symptomatic carriers of hemophilia and women with von Willebrand disease
or other bleeding disorders have special issues:
Prolonged menstrual bleeding and prolonged bleeding after childbirth
or miscarriage can be a problem. Long, heavy menstrual flows often lead
to low iron levels. Therefore, women with bleeding disorders should routinely
be tested for anemia.
To help control menstrual bleeding in some cases, doctors may prescribe
birth control pills or Stimate nasal spray. These will boost factor VIII
and von Willebrand factor levels.
If birth control pills or Stimate are not effective, more extreme
procedures might have to be considered. These might include a D&C (dilation
and curettage, a scraping of the lining of the uterus) or hysterectomy
removal of the uterus).
Medical and surgical options should be discussed by a woman and her doctor.
Decisions about what path to pursue should be based on personal preference,
family planning goals and severity of bleeding problems.
During pregnancy, levels of factors VIII and IX and von Willebrand factor
usually increase in women with bleeding disorders. For women with von Willebrand
disease, postpartum (after-delivery) bleeding may be treated with desmopressin
acetate or a von Willebrand-containing concentrate. A woman with a bleeding
disorder who becomes pregnant should see an obstetrician as soon as possible.
This will ensure that the doctor can work with the local hemophilia treatment
center to provide pre- and postnatal care for the woman and her fetus and
testing of the baby.
Miscarriages and abortions, even early in the course of a pregnancy, can
result in prolonged bleeding for women with bleeding disorders. Women with
bleeding disorders who know or think they are miscarrying, or who are choosing
to end a pregnancy, should promptly seek medical care. It's better to obtain
this treatment as soon as a woman learns she is pregnant.
For more information on "Women and Bleeding Disorders," visit
NHF's Project Red Flag Web site.
The information contained on the NHF web site is provided for your general
information only. NHF does not give medical advice or engage in the practice
of medicine. NHF under no circumstances recommends particular treatment
for specific individuals and in all cases recommends that you consult your
physician or local treatment center before pursuing any course of treatment.
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