In many people with von Willebrand disease (vWD), the signs are mild or they may be absent altogether. When signs occur, their intensity can vary from one person to another. Von Willebrand disease is often challenging to diagnose, especially in milder cases.
Abnormal bleeding is the most common sign of von Willebrand disease, although it may be present at only moderate levels.
The abnormal bleeding associated with von Willebrand disease may occur as:
- Recurrent and prolonged nosebleeds
- Bleeding from the gums
- Increased menstrual flow
- Excessive bleeding from a cut or following a tooth extraction or other dental procedure
- Blood in the stool or urine
- Bleeding from shaving with a razor or other similarly minor injury
People with von Willebrand disease may also experience:
- Easy bruising
- Bruises with lumps that form underneath the skin
Some people may realize that they have a bleeding disorder only after a surgical procedure or serious trauma in which excessive bleeding occurs.
Signs and symptoms of von Willebrand disease in women
Heavy menstrual bleeding is often the main sign of von Willebrand disease in women. However, women with von Willebrand disease may go undiagnosed because they're not overly concerned about their prolonged or heavy menstrual bleeding. And doctors may overlook heavy menstrual bleeding as a possible indicator of von Willebrand disease.
Signs and symptoms of an abnormally heavy period that may indicate von Willebrand disease include:
- The presence in your menstrual flow of blood clots greater than 1 inch (2.5 centimeters) in diameter
- The need to change your menstrual pad or tampon more often than hourly
- The need to use double sanitary protection to control menstrual flow
- Symptoms of anemia, including tiredness, fatigue or shortness of breath
When to see a doctor
Contact your doctor if you're experiencing extended or severe bleeding from any source.
If you're scheduled to have surgery (including dental procedures), make sure your doctor or dentist knows that you have von Willebrand disease, which can increase the likelihood of postsurgical bleeding. Also be sure to mention if anyone in your family has a history of excessive bleeding.
Consider wearing a medical ID bracelet noting that you have von Willebrand disease in case you are in an accident and are taken to an emergency room. Also carry a medical alert card in your wallet.
Jan. 02, 2014
- The diagnosis, evaluation, and management of von Willebrand disease. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/guidelines/vwd/index.htm. Accessed Sept. 11, 2013.
- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed Sept. 11, 2013.
- Berntorp E. Von Willebrand disease. Pediatric Blood Cancer. 2013;60:s34.
- Rick ME. Clinical presentation and diagnosis of von Willebrand disease. http://www.uptodate.com/home/index. Accessed Sept. 11, 2013.
- Rick ME. Treatment of von Willebrand disease. http://www.uptodate.com/home/index. Accessed Sept. 11, 2013.
- Facts about von Willebrand disease. U.S. Centers for Disease Control and Prevention. http://www.cdc.gov/ncbddd/vwd/facts.html. Accessed Sept. 11, 2013.
- Von Willebrand disease. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/hematology_and_oncology/thrombocytopenia_and_platelet_dysfunction/von_willebrand_disease.html. Accessed Sept. 11, 2013.
- What is von Willebrand disease? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/vwd/printall-index.html. Accessed Sept. 11, 2013.