You may develop a bleeding disorder if something in your body, such as a disease or a medicine, causes your body to stop making blood clotting factors or causes the blood clotting factors to stop working correctly. In addition, problems with your blood vessels can lead to bleeding.
Acquired bleeding disorders include:
Inherited bleeding disorders include the following:
Bleeding disorders can be caused by genes that are passed down from your parents. Your genes provide instructions for how each clotting factor is made. If there is a mutation in the gene, then the clotting factor may be made incorrectly or not at all.
How is hemophilia inherited?
Inherited hemophilia is caused by a defect in one of the genes for clotting factor VIII or IX. These genes are located on the X chromosomes. A male who has a hemophilia gene on his X chromosome will have hemophilia. When a female has a hemophilia gene on only one of her X chromosomes, she is a hemophilia carrier. If a female inherits a hemophilia gene from both parents, she can get hemophilia, but this happens rarely. Anyone with a hemophilia gene can pass the gene to their children.
Medical conditions, procedures, or medicines can cause bleeding disorders. Some medical conditions and medicines that lead to bleeding disorders cause your body to produce proteins, called antibodies or inhibitors, that can attack clotting factors.
Other medical conditions may cause your body to stop making clotting factors or to make too little of them. Certain medical devices or procedures can also affect clotting factors, as the pumping of blood through the area can affect the amounts of clotting factors.
Learn more in Risk Factors.
Bleeding disorders can happen at any age. However, newborns are more likely than adults to develop vitamin K deficiency bleeding. Acquired hemophilia A is more common among older people.
Bleeding disorders may run in families. You are at an increased risk of having a bleeding disorder if one or both of your parents have the disease.
Certain diseases or medical conditions can increase your risk for an acquired bleeding disorders, such as:
Certain treatments for medical conditions can also increase risk, including:
Hemophilia is much more common in men than in women. However, women are at increased risk for bleeding disorders, such as acquired hemophilia, during and after pregnancy.
Depending on your risk factors, your doctor may recommend screening your baby during your pregnancy using chorionic villus sampling (CVS). During CVS, the doctor threads a thin tube through the vagina to the placenta, where a tissue sample is collected using gentle suction. This test may be offered at 9 to 11 weeks to look for the hemophilia gene among women who are known hemophilia carriers, such as with hemophilia A or B. At a later stage during pregnancy, or after the baby is born, your doctor can do a blood test from the umbilical cord.
See Diagnosis for more information about diagnostic tests.
Inherited bleeding disorders, such as inherited or acquired hemophilia and von Willebrand disease, cannot be prevented. Couples who are planning to have children and know that they are at risk of having a child with a bleeding disorder may want to meet with a genetic counselor. A genetic counselor can answer questions about the risk.
Newborns are at an increased risk of vitamin K deficiency bleeding. To prevent a bleeding disorder caused by vitamin K deficiency, your baby will most likely get a vitamin K shot right after birth.
Signs, symptoms, and complications may differ depending on the type of bleeding disorder, its cause, and whether the disorder is mild or more serious. Signs and symptoms may be obvious soon after a child is born or not until adulthood. People who have a mild bleeding disorder may not have any signs or symptoms until they are injured or have a medical procedure.
Signs and symptoms of bleeding disorders may include:
Severe bleeding disorders can cause serious and life-threatening problems, including:
To help diagnose a bleeding disorder, your doctor may ask you questions such as these:
Your doctor will do a physical exam to look for signs of a bleeding disorder, such as bruising or petechiae. Your doctor may also look for signs of medical conditions that can cause bleeding disorders or signs of other medical conditions that can cause similar symptoms. Depending on the reason for your visit, the doctor may look for signs of bleeding-related complications, by looking for swelling and checking your blood pressure, heart rate, and breathing.
To diagnose a bleeding disorder and whether it may be inherited or acquired, your doctor may order one or more of the following tests.
For some bleeding disorders, such as hemophilia, the clotting factor test can tell you how severe the disorder is. Below are possible results from testing for hemophilia A:
For hemophilia A, the amount of factor VIII is measured and compared to normal amounts. If you have mild hemophilia, you would have 30% or less of the factor VIII levels that a person without a bleeding disorder would have. If you have moderate hemophilia, you would have less than 6% of normal factor VIII levels. If you have severe hemophilia, there would be no detectable levels of factor VIII.
Because bleeding can be caused by other medical conditions, your doctor may do tests or procedures to look for conditions that can cause acquired bleeding disorders, such as:
Treatment for bleeding disorders will vary depending on the disorder and may include medicines and factor replacement therapy. Your treatment may be every day to prevent bleeding episodes, or as needed when you plan for surgery or have an accident. You may not need treatment if your bleeding disorder is mild.
Bleeding disorders affect many parts of the body, so you will need a team of different doctors for your care. This includes a hematologist, a doctor who specializes in blood disorders. It may also include a specialized nurse, physical therapist, and social worker. You and your healthcare team may develop a treatment plan that is best for you depending on the bleeding disorder.
Medicines to treat bleeding disorders may include the following.
Factor replacement therapy is a type of treatment where clotting factors that are from blood donations or made in a lab are given to replace the missing clotting factor. Your doctor may recommend factor replacement therapy when you experience bleeding or to prevent bleeding from occurring. Treatment with replacement therapy on a regular basis to prevent bleeding is called prophylactic treatment. Prophylactic treatment is most often used for severe bleeding disorders.
Factor replacement therapy may include:
Learn more about how complications are managed in the Living With section.
If you are diagnosed with a bleeding disorder, it is important that you follow your treatment plan, receive routine care, maintain a healthy lifestyle, and learn how to lower your risk of complications. Know what steps you need to take if you have a child with a bleeding disorder. Women with bleeding disorders have unique needs, especially during pregnancy.
How often you see your doctor will depend on the severity of your bleeding disorder, your symptoms, and which treatments you are using. Even if you do not have symptoms and are not undergoing a treatment, you should see your doctor for ongoing care.
Return to Treatment to review treatment options.
After starting treatment, your doctor will check to make sure it is working. This may include blood tests right after treatment, and then regularly to see whether there is a change in the levels of clotting factors or antibodies within your blood.
Replacement therapy can cause major complications, which can include:
Return to Diagnosis to review the types of blood tests used for bleeding disorders.
Your doctor may recommend that you adopt lifelong heart-healthy lifestyle changes to improve your health and help reduce your risk of ischemic heart disease, which is very difficult to manage in people who have a bleeding disorder.
A healthy lifestyle includes:
To prevent or treat complications, your doctor may recommend the following.
Bleeding in the throat, abdomen, or brain can be a life-threatening complication of hemophilia. Call 9-1-1 if you or someone else has recently had an injury to the head, throat, or abdomen, or has the following.
Signs and symptoms of bleeding in the brain, which include:
Signs and symptoms of bleeding in the throat or digestive system, which include:
If you have a child with a bleeding disorder, talk with your child’s healthcare team. Get education and support from a hemophilia treatment center, support groups, and camps.
For children with moderate to severe hemophilia, your doctor may recommend replacement factor therapy on a regular schedule to help prevent spontaneous bleeding and to reduce bleeding from trauma. To help your child stay safe, your doctor may tell you to:
Talk with your child’s teachers and coaches about when to contact you and when to call 9-1-1.
Women who have a bleeding disorder have unique risks, such as heavy menstrual bleeding and pregnancy complications. Genetic carriers for hemophilia can also have bleeding complications, such as after childbirth, even though they may not have other symptoms. During pregnancy and childbirth and after childbirth, your doctor may suggest changes in your treatment plan and coordinating care with your hemophilia treatment center.
To stay safe living with a bleeding disorder:
Learn about the following ways the NHLBI continues to translate current research into improved health for people with bleeding disorders. Research on this topic is part of the NHLBI’s broader commitment to advancing blood disorders and blood safety scientific discovery.
Learn about some of the pioneering research contributions we have made over the years that have improved clinical care.
In support of our mission, we are committed to advancing bleeding disorder research in part through the following ways.
Learn about exciting research areas the NHLBI is exploring about bleeding disorders.
We lead or sponsor many studies on bleeding disorders. See if you or someone you know is eligible to participate in our clinical trials.
After reading our Bleeding Disorders Health Topic, you may be interested in additional information found in the following resources.