On the occasion of World Hemophilia Day which is recognized on 17 April each year, Hamad Medical Corporation (HMC) is urging women who have experienced symptoms of a bleeding disorder to get screened for hemophilia.
The World Health Organization (WHO) describes hemophilia as a hereditary bleeding disorder due to a partial or total lack of an essential blood clotting factor. Common symptoms of the bleeding disorder include frequent nosebleeds, unexplained and uncontrolled bleeding and bruising. “When a person without hemophilia bleeds, normal levels of clotting factor - a protein in the blood - causes the blood to clot and the bleeding to stop. However, hemophiliacs (people with hemophilia) have lower levels of clotting factor in their blood and bleeding continues for much longer periods,” explained Dr. Ahmed Abdulaziz Abdelbari (pictured), Clinical Pharmacist at Hamad General Hospital (HGH).
“An affected individual can bleed profusely for a longer time after trauma. These hemorrhages commonly occur in joints, especially the knees, ankles and elbows, and into tissues and muscles. Hemophiliac women are particularly at risk of excessive postpartum bleeding following childbirth, and can experience prolonged or heavy menstrual bleeding. They may require an iron supplement and sometimes need to undergo a hysterectomy (a surgical operation to remove all or part of the uterus). This is why it is important for women who carry the hemophilia gene to be aware of their status,” Dr. Abdelbari stated.
He further explained that symptomatic carriers and women with hemophilia may also bruise easily and experience prolonged bleeding after a surgery or trauma. It is a common misconception that only men have symptoms of hemophilia and that women who ‘carry’ the hemophilia gene do not experience symptoms themselves.
The World Federation of Hemophilia (WFH) says that many female carriers do experience symptoms of hemophilia, adding that some women live with their symptoms for years without being diagnosed or even suspecting they have a bleeding disorder. “Women with bleeding disorders are more likely to experience pain during their menstrual cycle (dysmenorrhea). They may also experience a small amount of internal bleeding during ovulation, which can cause abdominal and pelvic pain. This bleeding can be severe or even life-threatening, especially in carriers with very low clotting factor levels. They may require urgent medical attention,” explained Dr. Abdelbari.
The WHO says hemophilia A is the most common form, referred to as classical hemophilia, which is the result of a deficiency in clotting factor 8. Hemophilia B is a deficiency in clotting factor 9 and is a gender-linked recessive disorder. “Blood tests can determine the presence of the hemophilia condition, and more specifically whether it is a type A or a type B disease. It is always advisable for women to know their carrier status before becoming pregnant so they are better prepared to cope with their bleeding disorder. Families should consult their physician for advice and counseling about testing,” added Dr. Abdelbari.