Von Willebrand disease and hemophilia are bleeding disorders caused by issues with clotting factors. These conditions share similar symptoms, but identifying which one a person has is key to effective treatment.

young person with hemophilia or von Willebrand disease having a nosebleedShare on Pinterest
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When you get a cut or scrape, the platelets in your blood stick together and form a plug. Proteins in the blood — clotting factors — hold that plug in place, preventing prolonged bleeding and allowing the injured area to heal.

With bleeding disorders, these proteins do not work properly and do not stop the blood from flowing out of the blood vessel.

Von Willebrand disease and hemophilia are the most commonly inherited bleeding disorders. That means that these conditions are often present at birth — caused by a person’s genes.

Here’s more about how these conditions are similar, what their differences are, and how each is treated.

People with Von Willebrand disease (VWD) have issues with a protein called von Willebrand factor. When the levels of this protein are low or not functioning as they should, the blood cannot clot properly.

While rare, VWD is the most common inherited bleeding disorder classified into three main types:

  • Type 1 (mild): In this type, there are low levels of von Willebrand factor in the blood, and bleeding only becomes an issue during trauma, surgery, or tooth removal.
  • Type 2 (moderate): In this type, the von Willebrand factor in the blood doesn’t work as it should, and bleeding can be heavy and happens more often than in type 1.
  • Type 3 (severe): In this type, there is little to no von Willebrand factor in the blood, and bleeding frequently occurs from the nose, mouth, and gut.

Hemophilia is a rare genetically inherited bleeding disorder that can also range from mild to severe. People with hemophilia have deficiencies in the amount of either factor VIII (type A) or factor IX (type B). As with VWD, issues with these clotting factors can cause bleeding that does not stop.

It can be difficult to tell these two conditions apart with just a physical examination. One of the main differences is that hemophilia primarily affects males, whereas VWD affects both females and males. Another difference is that VWD tends to be milder than hemophilia.

If you believe you have a clotting disorder, your doctor will need to run coagulation tests to see exactly which protein is preventing your blood from clotting.

Language Matters

You’ll notice we use the binary terms “female” and “male” in this article. While we realize these terms may not match your gender experience, it’s the term used by the researchers whose data was cited. We try to be as specific as possible when reporting on research participants and clinical findings.

Still, the studies and surveys referenced in this article did not report data for or may not have had participants who are transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless.

The signs and symptoms of VWD and hemophilia are similar.

Shared symptoms include:

Where symptoms differ is that people with VWD may experience particularly heavy periods and bleeding from the nose and gums.

People with hemophilia may be more likely to experience painful or stiff joints and muscles from internal bleeding.

Treatment for hemophilia involves using synthetic injectable clotting factors to replace those that are missing or not working as they should. Healthcare professionals can prescribe these medications to prevent bleeding or to stop active bleeding.

Treatment for VWD depends on the severity. Individuals with mild VWD may not need treatment besides avoiding medications, such as aspirin, that thin the blood.

Those with more severe VWD may need medication to increase the levels of von Willebrand factor in their blood or in injected blood factors.

If you have either condition, speak with your doctor — a hematologist — before any surgeries, dental work, pregnancy/birth, or in any other event where the chance of bleeding increases.

A person is more likely to have VWD or hemophilia if they have a family history of the condition. The likelihood is higher if one or both parents have a bleeding disorder or otherwise carry an affected gene.

Again, males are at higher risk of having hemophilia than females. By contrast, VWD affects males and females in equal numbers, though women tend to experience more serious symptoms due to menstrual periods, pregnancy, and birth.

Currently, there is no cure for VWD or hemophilia. That said, the outlook depends on the severity of the condition.

People with mild types of VWD may lead relatively typical lives and only need synthetic clotting factors when they are injured or having surgery. Those with hemophilia and more severe types of VWD may need preventive clotting factors to avoid excessive bleeding in everyday life.

Are VWD and hemophilia always inherited?

No. While rare, these conditions can also be acquired as part of another medical condition or after taking certain medications.

How many people are affected by these conditions?

Experts estimate that VWD affects 1% of the population, regardless of sex. They estimate that hemophilia affects 1 in every 5,000 male births.

Why is hemophilia rare in females?

Since hemophilia is carried on the X chromosome, and females have two X chromosomes, the chances of having one healthy X chromosome are more likely, meaning hemophilia is rare in females.

Males have only one X chromosome, so if that X chromosome is affected, that male will have hemophilia.

You cannot necessarily tell which bleeding disorder you have from the symptoms alone. One valuable clue to the type is that both VWD and hemophilia are genetically inherited and may run in your family.

Your doctor or healthcare professional can order blood tests to determine which clotting factor isn’t functioning properly and prescribe appropriate medications to prevent and treat excessive bleeding.