Blood Disorders > Bleeding and Clotting Disorders in Women

Bleeding and Clotting Disorders in Women

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

• 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