Women

Could your period indicate a bleeding disorder?

Many older medical textbooks say that Haemophilia and bleeding disorders only affect men. These days Haemophilia specialists recognise that bleeding disorders effect women too.  However, old assumptions can take time to break down so raising awareness that bleeding disorders can affect women is an important part of our work.

The Haemophilia Society estimates that there are around 50,000 women/AFAB and girls with an undiagnosed bleeding disorder in the UK. 

Below there is a list of 9 signs and symptoms that could indicate that you are a woman (AFAB) with a bleeding disorder.

One of the symptoms is a heavy or prolonged period. But what does that actually mean?

A “normal period” is described as 60ml of blood loss over a cycle and a “heavy period” is described as 80ml or more over a cycle. To put that into context below is a table of what your average sanitary protection can hold:

Product TypeAverage CapacityNormal Cycle Usage
Regular TamponAround 5ml12 tampons
Super/Ultra TamponsAround 9-15mls7-4 tampons
Regular PadAround 5mls12 pads
Heavy/Overnight PadsAround 10-15mls6-4 pads
Small Menstrual CupAround 20-25mlChanged 3 times
Large Menstrual CupAround 30-40mlsChanged twice
Menstrual Cups can be worn up to 12 hours at a time, depending on the flow.

The NHS describes a heavy period as:

  • bleeding through your clothes
  • passing large clots, this could look like strawberry jam
  • having to change your period product more frequently
  • having to use 2 different products at the same time
  • having heavy periods every month that stop you doing everyday activities

What can you do if you are experiencing heavy periods or are not sure?

Please download our period tracker here, this allows you to track your period based on the NHS guidelines above. Lots of period tracking apps will only ask if your period was heavy on a day and not the intensity of the flow or how many products were used in that day.

We have created the period tracker to allow you to track for a full month. Most people with heavy periods/bleeding disorders will bleed for longer than a week and this tracker reflects this. It may also be that you have more than one period per month and this tracker allows you to record that too.

I have a heavy period and have tracked it, what next?

When you have completed a cycle and identified the bleeding is significant or prolonged the period tracker can be used as a tool to start the conversation with your GP, you can ask a friend or a relative to go with you to the appointment if you do not feel comfortable talking to the GP by yourself. You can also request to speak with a female GP at your clinic.

It may be helpful to have the information below prior to your appointment:

  • the first day of your last period (when it started)
  • how many days your period usually lasts
  • what was the shortest time between your periods (from the first day of one period to the first day of the next)
  • what was the longest time between your periods (from the first day of one period to the first day of the next)
  • how often you need to change your period products on a heavy day
  • if you are over 25, when you had your last smear test

NHS Scotland should follow the National Institute for Health and Care Excellence guidelines and should offer a discussion around key points such as:

  • the nature of the bleeding
  • related symptoms, such as bleeding in-between periods, or after sex, pain
  • impact on your quality of life
  • family history, do other members of the family also have heavy menstrual bleeding?

They should also offer a full blood count and a pelvic exam. You can request that they check both your iron and ferritin levels as this is not standard and a coagulation test if you suspect a bleeding disorder may be the cause.

They may offer other investigations including an Internal Vaginal Examination.

You can say no to this exam. You can ask to do it at another time and bring someone with you. The exam is usually with a speculum (metal or plastic instrument) and gloved fingers inside your vagina. They can feel the uterus and inside the pelvis and look for inflammation, infection or fibroids. (NHS leaflet)

It may be highlighted on the blood tests that your iron and/or ferritin levels are low due to your heavy periods, and you may require additional iron supplements.

Dr Gráinne O’ Brien, Clinical Psychologist

The doctor suspects a bleeding disorder what next?

Your doctor will refer you to a haematologist or a haemophilia centre, where an investigation can be carried out to make a diagnosis and identify the severity of the condition so that appropriate treatment can be given. It is likely that your entire family will also get tested, because it’s hereditary.

Check out our women’s support page for lots of extra information.

What happens at a Haemophilia Treatment Centre?

A doctor will carry out a thorough assessment of your medical history and ask questions, for example about bleeding symptoms, dental extractions and bruises. By taking several blood samples, the type of bleeding disorder and degree of severity can be established. Von Willebrand’s is hard to diagnose because levels of the von Willebrand factor can be affected by birth control pills, breastfeeding, pregnancy and infections.

Naomi’s Story of living with Von Willebrand’s

Free Period Products

The Scottish Government offers free period products to help tackle period poverty. You can find out where to collect free products near to you using my period live or by downloading the PickupMyPeriod app.

I have been diagnosed with something else, what next?

If you google your diagnosis and your area you should get results of local support. Please do reach out to see what they can offer. Below are some organisations we are aware of that offer support:

Your rights at work

Wellbeing of Women have a great resource that explains what your rights are as an employee.

Extra financial support

You may qualify for Adult Disability Payment if your heavy bleeding is interfering with your normal activities. Please speak to our Financial Wellbeing Officer to discuss this further.

Tell us about your experiences – this may help shape future changes

Heavy Menstrual Bleeding – Fill in form

We really hope that that you found the information contained in the webpage useful, if this has inspired you to start a conversation with your doctor please let us know how it went below:

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