The substantial impact of von Willebrand disease on menstruation

von Willebrand disease (vWd) is the most common of all congenital bleeding disorders with an estimated prevalence of 1–3% in the general population. However, the gynecological complications have not been thoroughly described. Objective: To compare the clinical and quality of life aspects of vWd in menstruating women in relation to a cohort of menstruating women in the general population. Methods: A patient questionnaire and provider survey of the medical and quality of life aspects of menstruation was administered to 81 menstruating vWd patients registered at four geographically linked Hemophilia Treatment Centers. The questionnaire was also administered to 150 menstruating women volunteers that comprised a control group used to determine normal coagulation levels in menstruating women. We assessed the impact on quality of life of menses in both of the cohorts by a Likert scale of 1–10 with 10 being “most significant impact” using 7 quality of life parameters with those comparisons by Wilcoxon rank sum test. Results: 88% of the vWd patients (pts) had type I vWd, the remaining Type II or unknown. The mean age of the vWd patients was 31.6 ± 10.3; the mean age of the control group was 35.5 ± 7.6. The following comparisons were made using χ 2 and Wilcoxon rank sum test: Controls vWd pts P value # of tampons/pads used for a typical menstrual cycle (mean ± SD) 20.3 ± 9.1 26.5 ± 14.8 .002 % reporting that clothes are stained by menses 20.4% 69.1% .001 Past or present history of anemia 1.3% 65.4% .001 Impact of menses on general activity (mean score) 1.1 ± 1.8 4.2 ± 3.0