Coagulopathy (bleeding disorders)

What is it?

A coagulopathy is a condition that affects how your blood clots, resulting in more bleeding during surgery, injury, delivery of a baby and/or menstruation. The most common coagulopathy that results in heavy menstruation is Von Willebrand Disease.

What are the symptoms?

Those with coagulopathies may have:

• Excessive bruising
• Frequent nosebleeds
• Bleeding gums or heavy bleeding during dental procedures
• Heavy menstrual bleeding
• Excessive bleeding during or after labour

What causes it?

Up to 10% of those who have heavy menstrual bleeding will have a coagulopathy. The most common cause is Von Willebrand disease. This is an inherited condition of low Von Willebrand factor. People with this condition can have difficulties with stopping bleeding, resulting in more blood loss.

How is it diagnosed?

This condition is usually diagnosed by a haematologist (a doctor specialising in blood disorders) by taking a blood test.

How is it treated?

There is no cure for Von Willebrand Disease but it can be managed by lifestyle changes and medications. Treatments for heavy menstrual bleeding include

• The oral contraceptive pill (https://www.nhs.uk/conditions/contraception/combined-contraceptive-pill/)
• An intrauterine system (hormonal coil) (https://www.nhs.uk/conditions/contraception/ius-intrauterine-system/)
• Desmopressin – available as a nasal spray or injection
• Tranexamic acid – available as tablets, a mouthwash or an injection
• Von Willebrand factor concentrate – available as an injection

Further information

https://www.nhs.uk/conditions/von-willebrand-disease/

https://www.nhs.uk/conditions/heavy-periods/treatment/