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Issues for girls and women with VWD

Menstruation

Women with VWD tend to have more symptoms than men because of menstruation and childbirth. Girls may have especially heavy bleeding when they begin to menstruate. Women with VWD often have heavier and/or longer menstrual flow. This heavier menstrual flow can cause anemia (low levels of iron in the blood, causing weakness and fatigue). Women with VWD should be checked regularly for anemia.

What is “excessive” bleeding?
Every woman is different, and what is considered “normal” for one woman may be “excessive” for another. The average amount of blood lost during a “normal” period is 30-40 mL. Blood loss of 80 mL or more is considered heavy. 

Of course, the amount of blood lost can be difficult to measure. If you believe you may suffer from excessive bleeding, complete the assessment chart during your next period. This is only a guide, but it can be a useful tool for you and your doctor to use when assessing your menstrual flow.

Pregnancy / childbirth

A woman with VWD should see an obstetrician as soon as she suspects she is pregnant. The obstetrician should work with a bleeding disorders treatment centre to provide the best care during the pregnancy and childbirth. During pregnancy, women experience an increase in VWF and FVIII levels. This provides better protection from bleeding during delivery. However, after delivery, these clotting factor levels fall quickly and bleeding can continue for longer than normal.

Menopause

Women with VWD entering menopause (end of menstruation, usually between the ages of 45 and 50) are at increased risk of unpredictable and heavy bleeding. It is important for a woman with VWD to maintain a strong relationship with her gynecologist as she approaches menopause.