Hemophilia and von Willebrand disease (VWD) are bleeding disorders that share similar symptoms. Both conditions make it more difficult for the blood to clot.

Both conditions can also be genetic, meaning a person inherits them from their biological parents. However, people can develop these disorders due to other factors, too. There are also differences in their symptoms and management.

Keep reading to learn about the differences and similarities between VWD and hemophilia, how doctors can tell them apart, and the treatment options.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Hemophilia and VWD are bleeding disorders that people typically inherit from their biological parents, meaning the conditions are present from birth. They both cause problems with clotting factors in the blood, which makes it harder for the blood to form clots.

This can be a problem if a person gets a cut or injury and the wound cannot stop bleeding or if a person needs a medical procedure, such as surgery. People who menstruate may also experience heavy periods.

Hemophilia is more common in males. People with this disorder may also experience muscle and joint discomfort due to bleeding. VWD has similar odds of occurring in any person, regardless of their sex.

Learn more about blood disorders.

The symptoms of hemophilia and VWD can be very similar, and may include:

  • bruising easily
  • large bruises
  • recurring or severe nosebleeds
  • excessive bleeding after a trauma or injury
  • heavy bleeding after dental procedures, vaccinations, or minor surgery
  • slower healing after surgery
  • heavy menstruation

People with hemophilia may also develop the following as a result of internal bleeding:

  • joint and muscle stiffness or pain
  • a buildup of blood under the skin, which healthcare professionals call a hematoma
  • blood in the urine or stool

To diagnose whether an individual has hemophilia or VWD, doctors need to perform a combination of tests and ask about the medical history of the person’s family.

The tests may include:

  • blood tests
  • screening tests to check if the blood is clotting properly
  • clotting factor tests to determine what type of bleeding disorder a person has

Doctors may also diagnose a condition based on a person’s symptoms. For example, if an individual is experiencing pain or stiffness in their joints, this may be a sign of hemophilia.

Hemophilia and VWD are both genetic conditions but are related to different chromosomes.

Chromosomes are DNA molecules that house genes, which control how bodies grow and develop. In humans, one pair of chromosomes influences their sex. Females have two X chromosomes, whereas males have an X and Y chromosome.

Hemophilia inheritance

Hemophilia usually occurs due to a difference in genes on the X chromosome.

Because females have two X chromosomes, the genes for hemophilia are less likely to affect them, as they have a higher chance of having at least one typical X chromosome.

If a female parent is a carrier of the gene, their male children have a 25% chance of developing hemophilia, and their female children have a 25% chance of carrying the gene.

Males will always pass their X chromosome to their daughters and their Y chromosome to their sons.

This means that male parents cannot pass hemophilia down to their male children, as they will pass on their Y chromosome. Their female children will have a 50% chance of becoming carriers.

VWD inheritance

In contrast, females and males have the same odds of developing VWD.

This is because VWD does not have links to the X chromosome. Any parent can pass it down to their children, regardless of sex.

A person may also develop this disorder even if their parents do not have VWD. This is because either parent may carry a gene for VWD without having symptoms.

Rare causes

In some rare cases, people may develop these disorders due to other conditions or as a side effect of taking certain medications.

Hemophilia treatment involves injections of synthetic clotting factors that help replace those that do not work or are missing.

This can help prevent or stop bleeding. Doctors may also prescribe medications that people with this condition have to take regularly to manage the disorder.

The treatment for VWD can vary depending on its severity. Milder cases may not need treatment apart from avoiding medications that thin the blood, such as aspirin. More severe cases may require injections of von Willebrand factor (VWF), a protein that helps blood clot.

Doctors may also recommend using a specific nasal spray called desmopressin acetate to help the body release more VWF and taking antifibrinolytic drugs, which prevent the breakdown of blood clots.

Here are answers to some common questions about VWD and hemophilia.

Is VWD a type of hemophilia?

No, VWD is not a type of hemophilia. Both conditions are bleeding disorders, but they are not the same illness.

Can you have both VWD and hemophilia?

As the conditions occur due to inherited changes in different genes, people can inherit the genes for both VWD and hemophilia.

Do females with hemophilia menstruate?

It is very rare for females to have hemophilia. Those that do can still menstruate, but they may have heavy periods.

That said, it is important to note that most females who carry a hemophilia gene do not have hemophilia. They only carry a copy of the gene. This sometimes results in symptoms, but these may be less severe.

Von Willebrand disease (VWD) and hemophilia are bleeding disorders that can cause similar symptoms, including excessive bleeding from cuts and wounds, recurring nosebleeds, easy bruising, heavy periods in females, and slow healing after surgery.

Both conditions are usually the result of genetics. Hemophilia is more prevalent in males, while people of all sexes have the same chance of developing VWD.

The treatments for each condition are different, so getting the correct diagnosis is important. People who have concerns that they may have a bleeding disorder should speak with a healthcare professional.