How is von Willebrand disease (VWD) treated?

Most cases of von Willebrand disease (VWD) are mild and require treatment only if the person is in an accident, undergoes surgery or dental procedures or has heavy bleeding with menstruation or childbirth. When the condition is more serious, there are several medications that might be suggested.

One common treatment for VWD is an artificial hormone called desmopressin, usually taken by injection or nasal spray. Desmopressin encourages the body to release more von Willebrand factor (VWF) and factor VIII. It has been proven successful in most people with type 1 VWD and some people with type 2 VWD.

Factor replacement therapy provides medicines rich in VWF and factor VIII to replace the missing factors in the blood. Typically, these are used to treat people with more severe forms of VWD or with milder forms that need prolonged treatment or don't respond well to desmopressin. The medicines are given through a vein in the arm.

Antifibrinolytic medications help prevent the breakdown of blood clots. They're mostly used to stop bleeding from the nose or oral cavity after minor surgery or injury and for heavy menstrual bleeding. They may be prescribed alone or in conjunction with desmopressin and factor replacement therapy. Birth control pills also may increase the levels of VWF and factor VIII in the blood and can reduce menstrual blood loss.

Pregnancy can prove challenging for women with VWD because they run an increased risk of bleeding problems during delivery and for an extended time after it. However, there are ways to lower the risk of such complications. If a women has VWD and is considering having a child, it's a good idea to talk with a hematologist and an obstetrician who specializes in high-risk pregnancies before becoming pregnant.

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