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Symptoms of inherited bleeding disorders in women

What are the general signs of a bleeding disorder?

Common signs of a bleeding disorder are:

  • bleeding from small skin cuts that start and stop over several hours
  • nose bleeds
  • bleeding from the mouth or gums
  • bleeding after tooth extractions
  • bleeding after a tonsillectomy
  • gastrointestinal bleeding (bleeding in the gut)
  • bleeding after an injury
  • bleeding after surgery.

What other signs of a bleeding disorder are seen in women?


Menorrhagia and metrorrhagia

Heavy, prolonged menstrual bleeding is the most common symptom for women with bleeding disorders.

Some women have heavy bleeding throughout the normal menstrual period. This is called menorrhagia.

Other women bleed throughout the month without stopping. This is called metrorrhagia.

Normally, all women lose a tiny amount of blood at mid-cycle of their period, the moment of ovulation, when the egg is ejected from the ovary. However, women with bleeding disorders can lose a large amount of blood at this time.

If women lose enough blood over a long period, they suffer from iron deficiency anemia.

Often, because a woman has always bled a lot during her menstrual cycle, and because many other women in the family also bleed a lot, she does not realize the menstrual flow is higher than normal. A blood flow assessment chart, in picture form, is available to help women and doctors measure the amount of bleeding. It is described by Higgins, et al (British Journal of Obstetrics & Gynecology, 1990).

Menstrual bleeding can be especially heavy at the time of a girl's first period. For this reason, when there is a family history of a bleeding disorder, she should be closely followed through puberty. The medical team should include:

  • a gynecologist
  • a hematologist with experience in treating bleeding disorders and
  • a family physician or pediatrician.


Dysmenorrhea and mid-cycle pain

Many women with bleeding disorders have pain during their menstrual period. This is called dysmenorrhea. They can also have pain at mid-cycle of their period, the moment of ovulation, if bleeding is heavy.

The cause of this pain is not known. It could be caused by the volume of blood and poorly formed clots in the uterus.

Some women can have a separate condition called endometriosis. With this condition endometrial tissue forms outside the uterus, for example, around the abdomen. When a woman menstruates, endometrial tissue - wherever it is in the body - bleeds. If these women also have a bleeding disorder, the bleeding may be heavy. The blood can irritate the abdominal wall, causing pain.