What are the symptoms of VWD in females?
The symptoms of VWD vary greatly from person to person. Bleeding often involves the mucous membranes (the delicate tissues that line body passages), such as the nose, mouth, uterus, vagina, stomach and the intestines.
The more common symptoms of VWD (von Willebrand disease or von Willebrand disorder) in females are:
- Frequent nosebleeds, or nosebleeds that are hard to stop
- Bruising easily
- Very heavy periods, or periods that last more than 8 days
- Bleeding for a long time from small cuts
- Bleeding from the gums, usually after trauma/injury
- Heavy bleeding that lasts longer than expected after childbirth (particularly when bleeding increases 3 days or more after giving birth)
- Bleeding that continues for a long time after injury, medical procedures, surgery or dental work.
Less common symptoms that older women may experience are:
- Blood in faeces (poo) due to bleeding in the intestines or stomach
- Blood in urine (wee) due to bleeding in the kidneys or bladder.
Females with severe forms of VWD, particularly type 3 VWD, may also have other bleeding problems similar to severe haemophilia, such as:
- Bleeding episodes that happen for no obvious reason
- Bleeding into joints and muscles which cause swelling and pain.
Heavy menstrual bleeding (also called abnormal uterine bleeding or menorrhagia) in women and girls with VWD may involve:
- Heavy menstrual periods (eg, soaking through a tampon and pad around two hourly, or needing to change during the night)
- Menstrual bleeding for longer than normal (eg, longer than 8 days)
- Bleeding with clots bigger than a 50 cent piece in size.
Heavy menstrual bleeding can lead to anaemia (low red blood cell count/low blood iron levels), with symptoms of fatigue, paleness, lack of energy and shortness of breath.
Some women and girls with VWD also experience:
- Pain during their menstrual periods (dysmenorrhoea)
- Abdominal pain and sometimes bleeding during ovulation (when an egg is released from the ovaries, around the middle of the menstrual cycle).
Although these can be symptoms of VWD, they can also be symptoms of a gynaecological disorder, so it is important to consult a gynaecologist.
If you are a woman or girl with VWD, a holistic or comprehensive care approach to your health care can help you to achieve better health and quality of life. Specialist gynaecological care over your lifetime is important to manage any gynaecological issues that occur. These may not be related to VWD, but in some cases VWD may make the bleeding problems worse.
Ideally your medical care team should work together on your health care and should include:
- A gynaecologist
- A haematologist specialising in bleeding disorders
- A GP or paediatrician or obstetrician, if relevant at the time