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How Is von Willebrand Disease Treated?

Treatment for von Willebrand disease (VWD) is based on the type of VWD you have and how severe it is. Most cases of VWD are mild, and you may need treatment only if you have surgery, tooth extraction, or an accident.

Medicines are used to:

  • Increase the amount of von Willebrand factor and factor VIII released into the bloodstream
  • Replace von Willebrand factor
  • Prevent the breakdown of blood clots
  • Control heavy menstrual bleeding in women

Specific Treatments

One treatment for VWD is a man-made hormone called desmopressin. You usually take this hormone by injection or nasal spray. It makes your body release more von Willebrand factor and factor VIII into your bloodstream. Desmopressin works for most people who have type 1 VWD and for some people who have type 2 VWD.

Another type of treatment is von Willebrand factor replacement therapy. This involves an infusion of concentrated von Willebrand factor and factor VIII into a vein in your arm. This treatment may be used if you:

  • Can't take desmopressin or need extended treatment
  • Have type 1 VWD that doesn't respond to desmopressin
  • Have type 2 or type 3 VWD

Antifibrinolytic (AN-te-fi-BRIN-o-LIT-ik) medicines also are used to treat VWD. These medicines help prevent the breakdown of blood clots. They're mostly used to stop bleeding after minor surgery, tooth extraction, or an injury. These medicines may be used alone or with desmopressin and replacement therapy.

Fibrin glue is medicine that's placed directly on a wound to stop bleeding.

Treatments for Women

Treatments for women who have VWD with heavy menstrual bleeding include:

  • Birth control pills. The hormones in these pills can increase the amount of von Willebrand factor and factor VIII in your blood. The hormones also can reduce menstrual blood loss. Birth control pills are the most recommended birth control method for women who have VWD.
  • A levonorgestrel intrauterine device. This is a birth control device that contains the hormone progestin. The device is placed in the uterus (womb).
  • Aminocaproic acid or tranexamic acid. These antifibrinolytic medicines can reduce bleeding by slowing the breakdown of blood clots.
  • Desmopressin.

For some women who are done having children or don't want children, endometrial ablation (EN-do-ME-tre-al ab-LA-shun) is done. This procedure destroys the lining of the uterus. It has been shown to reduce menstrual blood loss in women who have VWD.

If you need a hysterectomy (HIS-ter-EK-to-me; surgical removal of the uterus) for another reason, this procedure will stop menstrual bleeding and possibly improve your quality of life. However, hysterectomy has its own risk of bleeding complications.

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June 1, 2011