Von Willebrand disease (VWD) is an inherited bleeding disorder and unfortunately cannot be cured. It is a disease where the blood does not clot properly. People with the condition have low levels or underperforming von Willebrand factor (VWF), which is an important protein involved in the blood clotting process.

Types of VWD

• Type 1 – VWD factor levels are low – the most common.
• Type 2 – VWD doesn’t work properly.
• Type 3 – VWD factor is missing – the rarest form.

Facts about VWD

VWD is one of the most common bleeding disorders worldwide and affects approximately 1% of the population, both male and female. However, women are more likely to experience symptoms associated with VWD due to the bleeding which occurs during menstruation, pregnancy, and post-partum.

VWD and women

VWF, along with another important clotting factor, Factor VIII, increases during pregnancy and these changes aim to facilitate haemostasis after childbirth. Haemostasis is the body’s response to stop bleeding and involves complex interactions between cells, platelets and coagulation proteins such as Factor VIII.

Excess gynaecological bleeding is increased in women with VWD, with post-partum haemorrhage increasing 1.5 times. There is also a 5-fold risk of blood transfusion and a higher risk of death by 10-fold. Women with VWD also have an increased risk of post-partum bleeding up to 6-weeks following delivery; 30% compared to 2% among women without the condition.

Symptoms

If you have VWD, you may have the following general symptoms:

• Excessive bleeding from an injury or after dental work or surgery.
• Frequent nosebleeds which do not stop after about 10 minutes.
• Blood in the urine or stool.
• Easy bruising or lumpy bruises.

For women, the following symptoms may present:

• Heavy or long menstrual bleeding.
• Heavy bleeding during labour and delivery.
• Blood clots greater than 1 inch in diameter in your menstrual flow.
• The need to change your menstrual pad or tampon more than once an hour; or needing to use double pad protection.
• Anaemia, tiredness, fatigue or shortness of breath.

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References

• Data and Statistics on von Willebrand Disease | CDC
• Physiological Haemostasis - Mechanisms of Vascular Disease - NCBI Bookshelf (nih.gov)
• Von Willebrand disease - Symptoms and causes - Mayo Clinic
• Sadler, B., Castaman, G., & O’Donnell, J.S. von Willebrand disease and von Willebrand factor. Haemophilia. 2022;28(Suppl. 4):11–17
• Von Willebrand disease - types, symptoms, diagnosis and treatment | healthdirect