Addressing Abnormal Bleeding in the Mucous Membranes
If you or a female family member has factor VIII or factor IX levels below 40%, then you are at an increased risk of bleeding. Not all women who carry the hemophilia gene will have a low factor level. To determine if you are a carrier, the IHTC must also perform genetic testing of your factor VIII or factor IX gene.
In women, abnormal bleeding (suggestive of low factor levels) occurs in the mucous membranes. Mucous membranes are the pink tissues such as lining of the nose, mouth, and vaginal area. These tissues contain many blood vessels. Women may also have a similar bleeding pattern to that seen in men with mild hemophilia, including bleeding with trauma, surgery, and joint bleeding.
Heavy periods are seen in 40-50% of women who are carriers of hemophilia. Treatment for abnormal bleeding depends on the cause for the bleed, the type of factor deficiency, and personal history.
The IHTC can offer advice to you and your family on the best treatment options for your specific situation. Some treatments used include:
- Hormonal therapy, such as oral contraceptives, for treatment of heavy periods
- Antifibrinolytic drugs which prevent blood clots from breaking down, mostly used for mucous membrane bleeding
- DDAVP (FVIII deficiency only) to increase FVIII levels when given
- Factor infusion to treat bleeding episodes
For women with lower factor levels who are considering pregnancy, the IHTC recommends that care is managed in coordination with your OB/GYN. An individualized plan is made for the safe delivery and post-partum care of both the mother and the baby.
The IHTC offers both factor level determinations and genetic testing to affected women, and their blood-related female family members.
Call the IHTC for more information about genetic counseling and testing.