How Is von Willebrand Disease Treated?
Your doctor will decide what treatment you need
based on the type of von Willebrand disease (VWD) you have and how severe it
is. Most cases of VWD are mild, and you may need treatment only if you have
surgery, tooth extraction, or an accident.
Medicines are used to:
- Increase the release of von Willebrand factor
and factor VIII into the bloodstream
- Replace von Willebrand factor
- Prevent the breakdown of clots
- Control heavy menstrual bleeding in women
Specific Treatments
- Desmopressin (DDAVP) is a synthetic hormone that
you usually take by injection or nasal spray. It makes your body release more
von Willebrand factor and factor VIII into your bloodstream. DDAVP works for
most patients who have type 1 VWD and for some who have type 2 VWD.
- Von Willebrand factor replacement therapy is an
infusion of a concentrate of von Willebrand factor and factor VIII into a vein
in your arm. This treatment can be used if you:
- Cant take DDAVP or need extended
treatment
- Have type 1 VWD that doesnt respond to
DDAVP
- Have type 2 or type 3 VWD
- Antifibrinolytic drugs help prevent the breakdown
of blood clots. Theyre mostly used to stop bleeding after minor surgery,
tooth extraction, or an injury. They may be used alone or together with DDAVP
and replacement therapy.
- Fibrin glue is medicine thats placed
directly on a wound to stop the bleeding.
Treatments for Women
Treatments for women who have VWD with heavy
menstrual bleeding include:
- Combined oral contraceptives (birth control
pills). The hormones in these pills can increase the amount of von Willebrand
factor and factor VIII in your bloodstream and reduce menstrual blood loss.
Theyre the most recommended birth control method for women with VWD.
- A levonorgestrel intrauterine device. This is a
contraceptive device that contains progestin. Its placed in the uterus
(womb).
- Aminocaproic acid or tranexamic acid. These
antifibrinolytic drugs can reduce bleeding by slowing the breakdown of blood
clots.
- DDAVP.
For some women who are done having children or
dont want children, endometrial ablation is performed. This procedure
destroys the lining of the uterus. It has been shown to reduce menstrual blood
loss in women with VWD.
If you need a hysterectomy (surgical removal of the
uterus) for another reason, this procedure will stop menstrual bleeding and
possibly improve your quality of life. However, hysterectomy carries its own
risk of bleeding complications. |