Emergency? If you are soaking through a pad or tampon every hour, feel faint or short of breath, or might be pregnant and are bleeding with pain, call 911 or go to the nearest emergency room. Know the warning signs
Book now

Bleeding disorders

Some people bleed heavily because their blood does not clot normally. Von Willebrand disease, the most common inherited bleeding disorder, affects about 1 in 100 people, and most do not know they have it.

By the AUB editorial teamUpdated September 2026PALM-COEIN: AUB-C

Types

  • Von Willebrand disease: low or poorly working von Willebrand factor, a protein that helps platelets stick
  • Platelet function disorders
  • Clotting factor deficiencies, including carriers of hemophilia
  • Low platelet counts from other conditions

Heavy bleeding caused by blood thinners is classified separately, under medication-related causes.

Clues

  • Heavy periods since the first one
  • Frequent nosebleeds, bleeding gums, or easy bruising
  • Heavy bleeding after dental work, surgery, or childbirth
  • Family members with similar bleeding

Testing

Initial tests include a blood count and basic clotting tests. Von Willebrand testing measures several factors and can be affected by stress, estrogen, and pregnancy, so it is often coordinated with a hematologist and sometimes repeated.

Treatment

  • Hormonal options, including the levonorgestrel IUD and combined hormonal birth control
  • Tranexamic acid
  • Desmopressin for some types of von Willebrand disease, directed by a hematologist
  • Von Willebrand factor concentrates for severe bleeding or surgery
  • Iron replacement

Avoid aspirin and NSAIDs such as ibuprofen and naproxen if you have a bleeding disorder, unless your hematologist says otherwise. Make a bleeding plan before surgery, dental work, or childbirth.

Sources

  1. Connell NT, Flood VH, Brignardello-Petersen R, et al. ASH ISTH NHF WFH 2021 guidelines on the management of von Willebrand disease. Blood Adv. 2021;5(1):301–325.
  2. American College of Obstetricians and Gynecologists. Committee Opinion No. 785: Screening and management of bleeding disorders in adolescents with heavy menstrual bleeding. Obstet Gynecol. 2019;134(3):e71–e83.
  3. Munro MG, Critchley HOD, Fraser IS; FIGO Menstrual Disorders Committee. The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions. Int J Gynaecol Obstet. 2018;143(3):393–408.

Related