Treatment of VWD
VWD can be treated with a synthetic drug called desmopressin, with a clotting factor concentrate that contains VWF, or with other drugs that help control bleeding. The type of treatment depends in part on the type of VWD a person has. People with mild forms of VWD often do not require treatment for the disorder except for surgery or dental work.
Desmopressin is generally effective for treating Type 1 VWD, and helps prevent or treat bleeding in some forms of Type 2 VWD. It is used to control bleeding in an emergency or during surgery. It can be injected or taken by nasal spray, and raises VWF and FVIII levels to help blood clot. Desmopressin does not work for everyone. A doctor needs to do tests to find out if an individual responds to the drug. Ideally, tests should be done before treatment is needed.
Factor concentrates are used when desmopressin is not effective or when there is a high risk of major bleeding. Factor concentrates contain VWF and FVIII. This is the preferred treatment for Type 3 VWD, most forms of Type 2 VWD, and for serious bleeding or major surgery in all types of VWD.
Bleeding in mucous membranes (inside the nose, mouth, intestines or womb) can be controlled by drugs such as tranexamic acid, aminocaproic acid, or by fibrin glue. However, these products are used to maintain a clot and do not actually help form a clot.
Hormone treatment, such as oral contraceptives (birth control pills), helps increase VWF and FVIII levels and control menstrual bleeding. If hormone treatment is not prescribed, antifibrinolytic agents may be effective for treating heavy menstruation. Women who suffer from anemia (low levels of iron in the blood, causing weakness and fatigue) due to excessive menstrual bleeding may need to take iron supplements.
These treatments may have side effects, so people with VWD should talk to their physician about possible side effects of treatment.