Early symptoms of von Willebrand disease

The early symptoms of von Willebrand disease (VWD) revolve around some form of bleeding – which is fitting given that VWD is the most common inherited bleeding disorder, and it hinders the ability to clot blood. People with this condition have low levels of von Willebrand factor (VWF) – one of the proteins in the blood that helps the body stop bleeding. When VWF does not function properly, a clot takes longer to form at the site of an injury – or it may not form at all.

Von Willebrand disease symptoms


  • Start spontaneously.
  • Occur 5 times or more in a year.
  • Last longer than 10 times.
  • Require packing or cautery.

Easy bruising

  • Occurs with little to no trauma or injury.
  • Occurs 1-4 times a month.
  • Larger than a quarter.
  • Not flat.
  • Has a raised lump.

Heavy menstrual bleeding

  • Clots larger than a quarter are passed.
  • More than one pad is soaked through every couple of hours.
  • Anemia is diagnosed due to heavy period bleeding.

Bleeding longer than normal following injury, surgery, childbirth, or dental work

  • Lasting more than 5 minutes after a cut.
  • Heavy or longer bleeding that may stop and start again hours or days later after surgery.
  • Heavy bleeding during or after childbirth.
  • Heavy bleeding during or following dental surgery.
  • Surgery site that oozes blood longer than 3 hours after surgery.
  • Surgery site that requires packing or cautery.

Other bleeding

  • Blood in stool.
  • Blood in urine.
  • Bleeding into joints or internal organs in severe cases.


Like hemophilia, Von Willebrand disease is a hereditary disorder that is genetically passed on from parent to child. Unlike hemophilia, it affects not only men but also women. Symptoms of VWD in women include:

  • The presence of blood clots greater than 1 inch (2.5 centimeters) in diameter in the menstrual flow.
  • The need to change menstrual pads or tampons more often than hourly.
  • The need to use double sanitary protection to control menstrual flow.
  • Symptoms of anemia, such as tiredness, fatigue or shortness of breath.

The severity of the symptoms varies depending on the type of VWD, of which there are three.

Types of von Willebrand disease


The most common and mildest form of the condition, in which VWF is reduced but the symptoms may be so minor that the patient is not diagnosed.


The level of VWF is normal but the protein does not function properly.


Multimers – building blocks that make up VWF are unusually small or easy to break down.


VWF adheres to platelets a little too well, causing the platelets to clump and decreasing their number.


Low or absent VWF; severe symptoms.


Diagnosing VWD early is very important, especially for people with type 1 or 2 who may only experience major bleeding problems following surgery or trauma.

Diagnosis of von Willebrand disease

Medical history

  • Any bleeding from a small wound that lasted more than 15 minutes or started again in the first 7 days after the injury.
  • Any extended, heavy, or repeated bleeding that warranted medical attention following surgery or dental extractions.
  • Any bruising with little or no trauma, particularly if a lump can be felt under the bruise.
  • Any nosebleeds that occurred for no apparent reason and lasted more than 10 minutes in spite of pressure on the nose, or any nosebleeds that required medical care.
  • Any blood in stools for no known reason.
  • Any heavy menstrual bleeding, usually involving clots or lasting longer than 7-10 days.
  • Any history of muscle or joint bleeding.
  • Any medicines that might cause bleeding or increase the risk of bleeding (aspirin and other nonsteroidal anti-inflammatory drugs, clopidogrel, warfarin, or heparin). The doctor may suggest switching from those to acetaminophen.
  • Any history of liver or kidney disease, blood or bone marrow disease, or high or low blood platelet counts.

Physical exam

  • To check for abnormal bruising or other signs of recent bleeding.
  • To check for signs of liver disease or anemia.


  • Von Willebrand factor antigen.
  • Von Willebrand factor ristocetin cofactor activity.
  • Factor VIII clotting activity.
  • Von Willebrand factor multimers.
  • Platelet function test.


VWD treatment depends on the type and severity of the condition. As with the early symptoms of von Willebrand disease, treatment may be gender specific.

VWD treatment


  • Desmopressin Acetate Injection.
  • Desmopressin Acetate Nasal Spray.
  • Factor Replacement Therapy.
  • Antifibrinolytic Drugs.
  • Fibrin sealants.

For women

  • Birth control pills.
  • Levonorgestrel intrauterine devices.
  • Aminocaproic acid or tranexamic acid.


Barring the rare instances in which von Willebrand disease is acquired after birth, you can’t really prevent inheriting this condition if one or both parents have the gene for the disease, as it is a matter of chance. However, you can prevent bleeding episodes to a certain extent if you do the following:

  • Tell your doctor, dentists, employee health nurse, gym trainer, and sports coach that you have a bleeding disorder.
  • Consider wearing a medical ID bracelet if you have a severe form of the condition.
  • Exercise

-        Safe physical activities include swimming, biking, and walking.

-        Unsafe activities include football, hockey, wrestling, and lifting heavy weights.

-        Talk to your doctor before beginning an exercise regimen.

  • Keep a healthy weight.

Related: Do I have Anemia Symptoms?