Hemophilia Quick Facts
Bleeding Disorders among Women
- Bleeding disorders are particularly burdensome for females due to the monthly occurrence of menstrual periods and implications for reproductive health; menstruation, pregnancy, and childbirth represent recurrent hemostatic challenges to women with bleeding disorders.
- Bleeding disorders in women may be associated with an increased incidence of ovarian cysts, endometriosis, miscarriage, bleeding complications during pregnancy, and postpartum hemorrhage (PPH), which may necessitate a blood transfusion, hemostatic therapy, and even hysterectomy in severe cases.
- Women with bleeding disorders are more likely to experience PPH and are characterized by a maternal mortality rate 10 times higher than women without bleeding disorders.
- Females are treated similarly to males with bleeding disorders, adjusting the dosing range and schedule based on disease severity and type of bleeding episode.
- Clotting factor concentrate or recombinant clotting factor concentrate may be prescribed for those carrier females with clotting factors levels <50% of normal, typically in alignment with treatment protocols for mild hemophilia A or B.
- Considering these diverse physical and psychological complications associated with bleeding disorders in women, expert disease management is best delivered via the comprehensive care model through a hemophilia treatment center (HTC).
Byams VR, Kouides, PA, Kulkarni R, et al. Surveillance of female patients with inherited bleeding disorders in United States Haemophilia Treatment Centres. Haemophilia. 2011;17:6–13.
James AH, Jamison MG. Bleeding events and other complications during pregnancy and childbirth in women with von Willebrand disease. J Thromb Haemost. 2007;5:1165–1169.
Centers for Disease Control and Prevention. Hemophilia treatment centers (HTCs). http://www.cdc.gov/ncbddd/hemophilia/htc.html.
Jennifer Maahs, RN, PNP, MSN
Indiana Hemophilia and Thrombosis Center
Vanita K. Pindolia, PharmD, BCPS
Vice President, Ambulatory Clinical Pharmacy Programs_PCM
Henry Ford Health System/Health Alliance Plan of Michigan
Steven W. Pipe, MD
Director, Division of Pediatric Hematology and Oncology
Pediatric Medical Director, Hemophilia and Coagulation Disorders Program
University of Michigan
Marion Koerper, MD
Professor Emerita on Recall
Department of Pediatric Hematology
School of Medicine University of California, San Francisco
(UCSF) School of Medicine
National Hemophilia Foundation
Diane J. Nugent, MD
Medical Director, Hematology and Blood and Donor Services
Division Chief, Hematology
Children’s Hospital of Orange County
Celynda G. Tadlock, PharmD, MBA
Vice President Pharmacy Business Development, Aetna
President, Coventry Prescription Management Serivces, Inc.