We don’t hear much about them, but bleeding disorders are currently affecting hundreds of thousands of people across the world. It’s important to know the symptoms so that you can get on top of it sooner rather than later.
Clinical haematologist Dr Jackie Thomson explains exactly what a bleeding disorder is.
“A bleeding disorder is defined as bleeding more than expected, or spontaneous bleeding in a patient. Essentially, it’s a delay in clotting, which can lead to excessive bleeding,” she says.
When a person gets injured their blood begins to clot to prevent massive blood loss. Someone with a bleeding disorder would typically experience heavy or prolonged bleeding because certain bleeding disorder conditions prevent their blood from clotting properly.
According to the US Department of Health and Human Services, about 1 in 10 women with heavy menstrual periods may have a bleeding disorder.
The different types
Dr Thomson explains that some bleeding disorders are inherited, while others are acquired. Bleeding disorders that are acquired can develop quite early on in someone’s life but sometimes only occur later in life.
While there are several different bleeding disorders, there are three main/common ones:
Haemophilia A/Haemophilia B: These conditions occur when your blood has low levels of clotting factors, so your blood doesn’t clot in the way it’s supposed to. Haemophilia is mostly inherited and affects males more than females.
Von Willebrand’s disease: Von Willebrand’s disease is the most common bleeding disorder affecting women. It’s caused by a deficiency or defect in the body, which hampers its ability to produce a particular protein (Von Willebrand factor) that helps blood clot.
Factor II, V, VII, X or XII: These are deficiencies related to blood clotting issues and abnormal bleeding issues.
Symptoms to look out for
A research paper published in the highlights the fact that abnormal bleeding is something clinicians see often – so thorough measures must be taken to give the diagnosis.
“Investigation of a suspected bleeding disorder necessitates a comprehensive history, thorough physical examination and systematic laboratory work,” the paper says.
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While there are several symptoms associated with bleeding disorders, the most common ones for women are related to their menstrual experience.
“It usually presents in prolonged bleeding from a women’s menstrual cycle,” Dr Thomson explains. “Women usually bleed for 3-5 days every 28 days and only the first two days are heavy. Women with a bleeding disorder will bleed for longer and will have more heavy flow days.”
Other symptoms include:
- Frequent nosebleeds.
- Excessive bleeding from small cuts or an injury.
- Bruising easily.
If you’re not too sure how to identify a heavy menstrual period, here are the three indicators:
- Soaking through a pad or tampon every 1 to 2 hours.
- Menstrual bleeding that goes on for longer than 7 days.
- Menstrual blood with clots bigger than a 50c coin.
If you experience any of these symptoms, then it is important to get in touch with your doctor and have him perform the necessary tests to offer an accurate diagnosis.
“Depending on the diagnosis, the patient will need either oral tablets or blood product replacement,” Dr Thomson says.
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What happens when you’re not treated?
If a bleeding disorder is diagnosed and treated too late (or not diagnosed and treated at all), a couple of intense complications could come into play. Some of these include internal bleeding in the intestines, the brain and in your joints, which can be life-threatening in certain instances.
A couple of complications could arise that are unique to women. If untreated, the risk of excessive bleeding during childbirth, miscarriage or an abortion is increased significantly. Heavy menstrual bleeding can also cause anaemia (an iron deficiency), which could lead to dizziness, shortness of breath and general fatigue.
What are the treatment options?
The treatment for bleeding disorders depends on the type of disorder and how mild or severe your case is. Bleeding disorder unfortunately can’t be cured, but the symptoms can be managed.
You might be given an iron supplement to counteract the iron lost through a substantial loss of blood. Another treatment, for more severe cases, is a blood transfusion to replace a significant amount of blood loss.
Another treatment option is factor replacement therapy where clotting factor concentrates are injected directly into your bloodstream to control and prevent excessive bleeding.
