Many women with a bleeding disorder experience heavy, painful menstrual periods that may last for more than a week, disrupting sexual and general health. However, you don't have to endure this complication of your bleeding disorder. You do have other options to help you enjoy a healthy and satisfying sex life.
This section of Sexual Health and Reproductive Issues looks at some of the issues facing women with a bleeding disorder, including:
Heavy, Painful, and Long-Lasting Menstrual Periods
The average menstrual period lasts anywhere from 2 to 7 days. In contrast, many women with bleeding disorders experience:
- Periods lasting more than 7 days
- Periods that pass clots the size of a quarter
- Periods requiring more than one pad every 2 hours
- Iron deficiency
- Painful periods
- Heavy bleeding and hemorrhaging after childbirth
Treatments for Heavy Menstrual Periods
You do not have to suffer with heavy periods (called menorrhagia). The first thing you can do is to talk your obstetrician/gynecologist (OB/GYN) about your bleeding disorder. If your OB/GYN has not treated many women with bleeding disorders and would like to learn more, you can suggest that he or she speak to a healthcare provider (HCP) at your hemophilia treatment center (HTC). After taking these steps, if you are not satisfied with your OB/GYN's response to your health concerns, it's perfectly acceptable for you to ask for a second opinion and consult with a different doctor.
Here are some types of treatment for heavy menstrual bleeding that you and your doctor might find right for you:
- Hormonal Therapy. This treatment may reduce how often you get your period, how heavy it is, and how long it lasts. Hormonal therapy does have side effects, however, and you'll have to work with your doctor to find the one best for you.
- Antifibrinolytic Therapy. This includes drugs like epsilon-aminocaproic acid and tranexamic acid. A new formulation of tranexamic acid is FDA approved for treatment of menorrhagia.
- Desmopressin. Desmopressin, or DDAVP, can increase factor VIII (8) and von Willebrand factor levels and can be used for treatment of heavy menstrual bleeding, particularly in the intranasal forms.
- Factor Replacement Therapy. Some women with severe bleeding disorders receive factor replacement, which consists of regular infusions of the deficient clotting factor.
- Surgical Options. One surgical option is endometrial ablation, where the uterus is scarred, and can be used in women who have finished childbearing. In extreme cases of heavy menstrual bleeding, when other treatments are not effective, and when you no longer want to preserve your fertility, your doctor may suggest a hysterectomy.
In addition to bleeding disorder-specific complications with menstrual periods, women with bleeding disorders or symptomatic carriers should be aware of the health issues that all women face. These include:
- Ovarian cancer