Common Signs and Symptoms

Women, girls, and people who have or had a potential to menstruate (WGPPM) can have von Willebrand disease (VWD), hemophilia, rare factor deficiencies, and rare platelet disorders. Bleeding often goes misdiagnosed or undiagnosed. This can put people at risk for unnecessary medical procedures, heavy bleeding after surgery and dental procedures, injuries due to childbirth, and problems during pregnancy or heavy menstrual periods. 

If you have symptoms of a blood or bleeding disorder, it is important to get an accurate diagnosis and treatment from a hematologist. A hematologist is a health care provider that specializes in diseases or disorders of the blood. In the United States, the network of Hemophilia Treatment Centers (HTCs) provides comprehensive care to people who have bleeding disorders.   

If you want more information about how to find an HTC near you, please go to the CDC HTC Search Directory.  

This section of Basics of Bleeding Disorders covers: 

Heavy Menstrual Bleeding

Common Signs of Bleeding Disorders in WGPPM

Diagnosing Bleeding Disorders for WGPPM

Finding Resources

Heavy Menstrual Bleeding

One of the most common signs of a bleeding disorder in women, girls, and people who have or had the potential to menstruate is heavy menstrual bleeding (HMB). Often, HMB is the first recognizable sign of a bleeding disorder. You may not think your period is abnormal because you have always had heavy periods or other family members also have heavy periods. If your period lasts more than 7 days, you may have heavy menstrual bleeding. Other signs include: 

• You use more than one pad or tampon every hour. 

• You need to double up by wearing one pad and a tampon because of heavy bleeding. 

• You need to change pads or tampons more than once during the night. 

• You have a menstrual flow that repeatedly contains blood clots the size of a quarter or larger. 

• You have a menstrual flow so heavy that it keeps you from doing the things you would do normally, such as going to work, school, or other activities. 

HMB can be due to other disorders as well, so if you are experiencing heavy menstrual bleeding talk with your health care provider. 

If you want more information about heavy menstrual bleeding, please go to What to Know. 

Common Signs of Bleeding Disorders in WGPPM

Since bleeding disorders in WGPPM are often undiagnosed or misdiagnosed, it is important to know the signs and symptoms of a bleeding disorder. Here are some signs that may indicate a bleeding disorder in women, girls, and people who have or had the potential to menstruate:  

• Heavy menstrual bleeding (HMB) 

• Your iron is low, or you have been treated for anemia 

• You have a family member with a bleeding disorder, such as von Willebrand disease (VWD) or hemophilia 

• You have a family member who has one or more symptoms of a bleeding disorder 

• You have experienced heavy bleeding after surgery (including dental surgery) 

• Frequent nosebleeds that last longer than 10 minutes 

• Bleeding from cuts or injuries that last longer than 10 minutes  

• Bleeding that starts up again within the first seven days following surgery 

• Bruising easily, with bruises that are raised and larger than a quarter 

• An episode of blood in the stool for no apparent reason 

• A history of muscle or joint bleeding 

• Heavy bleeding after childbirth or miscarriage 

Diagnosing Bleeding Disorders for WGPPM

For women, girls, and people who have or had the potential to menstruate, it may take years to be diagnosed with a bleeding disorder. Many WGPPM are not tested before puberty, as heavy periods are a symptom of a bleeding disorder. If you have these symptoms, it is important to talk with a health care provider or go to a Hemophilia Treatment Center (HTC). Many health care providers may be unfamiliar with the signs and symptoms of bleeding disorders, delaying diagnosis, treatment, and care.   

NBDF, in partnership with the Centers for Disease Control and Prevention (CDC), created the Better You Know campaign to spread the word about bleeding disorders to undiagnosed women and health care providers. On Betteryouknow.org there is a risk assessment tool that will let you know if you are at risk for a bleeding disorder, information and educational resources for health care providers, and ways to spread the word on social media. There are also tools and resources to help you advocate for your needs and take steps towards a diagnosis.    

If you want more resources about self-advocacy at a health care provider appointment, please go to Don’t Miss the Signs: Bleeding Disorders in WGPPM. 

Finding Resources

There are several resources for WGPPM below, including links to websites that support women, girls, and people who have or had the potential to menstruate, as well as information about coexisting conditions, sexual health, pregnancy options, menopause, and hormonal therapies.