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Blood Disorders > Bleeding and Clotting Disorders in Women |
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Bleeding and Clotting Disorders in
Women
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Bleeding and
clotting disorders pose important problems for women because of
the relationship of these disorders to reproductive issues. These
problems include heavy menstrual bleeding (termed menorrhagia),
bleeding and clotting complications of pregnancy, and recurrent
fetal loss.
Menorrhagia can
be incapacitating for some women and may suggest a bleeding
disorder. Current research supports the hypothesis that a
significant number of cases of unexplained menorrhagia may be due
to an underlying bleeding disorder. Other symptoms of a bleeding
disorder might include unusually hard-to-control bleeding after
minor injury, childbirth, or surgery; excessive bleeding from the
gums after flossing, brushing, or having a tooth removed;
frequent or long nosebleeds; and easy bruising.
The most common
bleeding disorder is von Willebrand disease (VWD). VWD results
from a deficiency or defect in the body's ability to make von
Willebrand factor, a protein that helps blood clot. Although VWD
occurs in men and women equally, women are more likely to notice
the symptoms because of heavy or abnormal bleeding during their
menstrual periods and after childbirth. The American
College of Obstetricians and Gynecologists has made
recommendations to screen women with menorrhagia for VWD.* Women
who should be tested include
-
adolescents with
severe menorrhagia (they should be tested before hormone therapy
is prescribed)
-
adult women with
significant menorrhagia that cannot be explained by other causes
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women who are
about to have hysterectomies for excessive menstrual bleeding
Although there is
no cure for these bleeding disorders, treatment is available to
control symptoms once a disorder is identified. Bleeding can be
controlled with medications.
*For more
information see Von Willebrand's disease in gynecology
practice. ACOG Committee Opinion No. 263. American College of
Obstetricians and Gynecologists. Obstet & Gynecol
2001;98:1185-1186.
Prevention activities
CDC is helping to
expand the scope of a network of specialized health-care centers for hemophilia to include
bleeding and clotting disorders specific to women. This network
promotes the management, treatment, and prevention of
complications experienced by persons with these disorders.
CDC is working
with the National Hemophilia Foundation to encourage
gynecologists to consider bleeding disorders in women who have
menorrhagia. CDC is developing a short screening questionnaire to
help doctors decide which of these women should be tested for a
bleeding disorder.
CDC is a partner
in the National Hemophilia Foundation's public awareness
campaign,
Project Red Flag, to help women recognize the symptoms of
bleeding disorders.
CDC has
established a surveillance system, the
Universal Data Collection project, to monitor blood safety
and to conduct research on health-care outcomes. The system is
integrated into the specialized health-care network.
For more information
Locate a specialized health-care center
Hemophilia Treatment Center Directory and Universal Data
Collection project database
Publications
Philipp C, Faiz A, Dowling
N, Dilley A, Michaels L, Ayers C, Miller C, Bachmann G, Evatt
B, Saidi P.
Age and the Prevalence of Bleeding Disorders in Women With
Menorrhagia . J Obstet Gynecol 2005;105:61-66.
Development of a
screening tool for identifying women with menorrhagia for
hemostatic evaluation
This article was published in the American Journal of Obstetrics
and Gynecology, Vol 198, Philipp C, Faiz A, Dowling N, Beckman
M, Owens S, Ayers C, Bachmann G. Development of a screening tool
for identifying women with menorrhagia for hemostatic
evaluation, Pages 163.e1-163.e8., Copyright Elsevier (2008).
Full Text:
PDF format (282 KB)
Bleeding Disorders in Women: Questions and Answers for Newly
Diagnosed Women
PDF format (17 KB)
Dilley A. Bleeding disorders in women: the CDC program. HemAware
2003;8(1):47-49. (304 KB)
UDC Surveillance Report;
December 2003: Special report summarizing data on females with
Von Willebrands Disease (209 KB)
Dilley A, Drews
C, Miller C, Lally C, Austin H, Ramaswamy D, Lurye D, Evatt B.
von Willebrand disease and other inherited bleeding disorders in
women with diagnosed menorrhagia. Obstet Gynecol
2001;97:630-636.
Dilley A, Austin
H, El-Jamil M, Hooper WC, Barnhart E, Evatt BL, Sullivan PS,
Ellingsen D, Patterson-Barnett A, Eller D, Randall H, Philipp C.
Genetic factors associated with thrombosis in pregnancy in a
United States population. Am J Obstet Gynecol
2000;183:1271-1277.
Dilley A, Crudder
S. von Willebrand disease in women: the need for recognition and
understanding. J Womens Health Gend Based Med 1999;8(4):443-445.
Trends in clinical management
of women with von Willebrand disease: a survey of 75 women enrolled
in hemophilia treatment centers in the United States, A. Kirtava, S.
Crudder, A. Dilley, C. Lally, B. Evatt, Haemophilia (2004), 10,
158-161
Organizations
National Hemophilia
Foundation
•
information on
various types of bleeding disorders
•
Project Red Flag: Real Talk About Women's Bleeding Disorders
International Society on
Thrombosis and Haemostasis
American Society of
Hematology
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Disclaimer: Links to non-Federal
organizations found at this site are provided solely as a service to
our users. These links do not constitute an endorsement of these
organizations or their programs by CDC or the Federal Government, and
none should be inferred. CDC is not responsible for the content of
the individual organization web pages found at these links.
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Date: November 21, 2005
Content source: National Center on Birth Defects and Developmental
Disabilities
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