Bleeding Disorder Types, Causes, and Treatments

A bleeding disorder, sometimes called coagulopathy, is a condition that makes you more likely to bleed than the average person. If you have a bleeding disorder, this means your body does not clot properly, typically due to a defect of one or more steps of the coagulation (bleeding and clotting) system. Some bleeding disorders are hereditary, while others develop due to a medical illness that arises later in life.

This article describes common bleeding disorders, their symptoms, causes, and treatments.

The coagulation system should be in balance—not too much bleeding but also not too much clotting. The blood clotting process involves platelets, a type of blood cell, and coagulation factors, which are proteins in the blood.

Symptoms 

The symptoms and severity of bleeding disorders can vary greatly. Some people experience frequent bleeding, while others may not experience the effects of a bleeding disorder unless they are having surgery or have had a serious injury.

Common symptoms of bleeding disorders:

• Frequent or prolonged nosebleeds
• Recurrent or prolonged bleeding of the gums
• Heavy menstrual bleeding (previously called menorrhagia)
• Excessive postpartum (after delivery) bleeding
• Prolonged bleeding after a needle stick (blood draw or injection like a vaccine)
• Excessive bleeding during or after surgery that requires additional efforts to stop bleeding
• Large bruises, which may form lumps

Just because you may experience one of these symptoms does not mean you necessarily have a bleeding disorder.

Types and Causes

There are many different types of bleeding disorders. Some are inherited with a known familial pattern, and some may develop due to a medical condition, or from taking certain medications. While some bleeding disorders may be reversible (such as vitamin K deficiency), most bleeding disorders are chronic and require lifelong therapy.

Familial Blood Disorders

Some bleeding disorders like hemophilia and von Willebrand disease are hereditary. These are usually present from birth, and diagnostic tests may show abnormalities in clotting factors.

Hemophilia

People with hemophilia are missing coagulation factors. The type of hemophilia depends on which factor is missing.

• The most common type is hemophilia A, which occurs due to a deficiency of factor 8 from the coagulation system.
• Hemophilia B is a deficiency of factor 9.
• Hemophilia C is a deficiency of factor 11.

Hemophilia is inherited in an X-linked recessive hereditary pattern, so males are more commonly affected. People with hemophilia can have significant bleeding from injuries or spontaneous (without injury) bleeding.

Von Willebrand Disease

Von Willebrand disease (VWD) is the most common bleeding disorder in the world. It is estimated that 1% of the population has some form of von Willebrand disease. VWD is inherited, and both males and females can be equally affected. The amount of bleeding can vary greatly depending on what type of VWD a person inherits.

Platelet Disorders

If you don’t have enough platelets or if they can’t function properly, it can affect your body’s ability to form a proper clot, which may result in bleeding.

Low Platelet Count (Thrombocytopenia)

There are numerous causes of a low platelet count, including ​leukemia, chemotherapy, and immune thrombocytopenia (where the immune system destroys the platelets).

Platelet Function Disorders

Even with a normal number of platelets, if these cells do not function properly, bleeding may occur.

Acquired

Several health conditions can lead to bleeding disorders.

Autoimmune

Some people may develop acquired hemophilia due to the development of antibodies to clotting factors. This can occur during pregnancy, as the result of cancer, autoimmune disease, a medication reaction—or it can be idiopathic (without an identifiable cause).

Vitamin K Deficiency

Several of the coagulation factors require vitamin K to function properly, so people who are vitamin K deficient are more likely to bleed too easily. This deficiency can occur due to malnutrition or an absorption problem in the gastrointestinal system.

Anticoagulation Therapy

People who take anticoagulation therapy (medications that prevent clotting) are at increased risk of bleeding. These medications are often prescribed to reduce the risk of a stroke or heart attack for people who are at high risk, such as due to atrial fibrillation.

Usually, the dose is carefully adjusted to prevent bleeding. But sometimes medication interactions or interactions with alcohol can increase the risk of bleeding.

And rarely, people may develop a serious reaction to anticoagulation therapy, and the risk of bleeding may remain even when the medication is discontinued.

Liver Disease

The coagulation factors are made predominantly in the liver. People with severe liver disease are unable to produce adequate coagulation factors and therefore are more likely to experience significant bleeding.

Treatment 

There are many possible treatments that can help prevent excessive bleeding. If you have been diagnosed with a bleeding disorder, the treatment your healthcare provider will prescribe is based on the cause of the bleeding disorder.

• Factor replacement: People living with hemophilia can infuse themselves with factor replacement products. If you have this condition, your healthcare providers would teach you to infuse factor replacements on a schedule to prevent bleeding episodes.
• Desmopressin: Desmopressin is a replacement product for the hormone vasopressin. Taking desmopressin results in a temporary increase in von Willebrand antigen and factor 8, which may help prevent bleeding for people who have mild hemophilia A or von Willebrand disease.
• Platelet transfusions: If your platelet count is low or your platelets do not function as they should, you might need a platelet transfusion to prevent and treat bleeding episodes.
• Fresh frozen plasma: Coagulation factors are found in the plasma (liquid component of blood). If you’re missing several different factors, such as due to liver failure, you might receive an infusion of fresh frozen plasma.
• Vitamin K: If you are vitamin K deficient, supplementation can be given.
• Antifibrinolytics: These medications prevent excessive bleeding by stabilizing blood clots. These are primarily used to control bleeding in the mouth or heavy menstrual periods.

A Word From Verywell

It can be scary to receive a diagnosis of a bleeding disorder. Excessive bleeding can be dangerous—it can lead to blood loss, fainting, organ damage, and it may even be fatal. That said, you can live a healthy and active life with a bleeding disorder. Talk to your healthcare provider about what precautions you may need to take, when to call for medical attention, and how to stay active.