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Von Willebrand Disease

Von Willebrand disease (VWD) is the most common type of bleeding disorder, affecting up to 1% of the world’s population. Unfortunately, bleeding symptoms are not always recognized as abnormal, so only a small number of affected individuals have been diagnosed.

Some people have such mild cases that they never know they have the disease. With all forms of VWD, however, bleeding episodes can be severe and may require treatment, particularly during or following surgery or dental work. The diagnosis of VWD is complex and should be made by physicians experienced in the treatment of bleeding disorders.

All types of VWD are inherited in an autosomal pattern. This means that men and women are affected in equal numbers.

Common symptoms of VWD are:

• easy bruising
• bleeding from nose and gums
• prolonged bleeding from skin lacerations
• bleeding from the gums when baby teeth fall out or after tooth extractions
• heavy or prolonged bleeding during menstruation, called menorrhagia.

Symptoms of VWD can begin at any age. The signs are:

• bruises from minor bumps
• nose bleeds
• prolonged bleeding from minor cuts.

In cases of severe Type 3 VWD, bleeding can occur in newborns, especially from the umbilical cord and at the time of circumcision. These types of bleeding can also occur with Types 1 and 2 VWD, but only in rare cases.

Menorrhagia seriously affects a woman’s quality of life. Here are some examples. Women with menorrhagia caused by VWD may…

• limit the amount of time they work
• change careers as a result of bleeding problems
• be unable to work normally during their menstrual periods
• have lost faith in the medical profession after being told for years that their problems were not real
• suffer constant fatigue from iron deficiency anemia
• suffer from depression as a result of the strain of their bleeding disorder
• suffer pain during their menstrual periods and times of ovulation
• have increased episodes of ovarian cysts, pain, internal bleeding and risk of subsequent surgery with potential loss of the ovaries
• live with the embarrassment of staining due to heavy bleeding
• have had hysterectomies because doctors did not diagnose a bleeding disorder. This meant they had unnecessary surgery and could not have any more children.

Happily, with proper diagnosis and treatment, these problems can be dramatically reduced and even eliminated.