Treating and Managing a Bleed

There are many different types of treatment for rare bleeding disorders, which is appropriate for you will depend on the disorder you have. There is information in our factsheets on the exact treatment that doctors use for each one.

This section contains a summary of all treatments that are used.

Factor concentrates
This is the ideal treatment for a bleeding disorder as it replaces the missing or faulty factor. Unfortunately, factor concentrates are not available for all bleeding disorders, but more research is being carried out to manufacture treatments for those not yet covered.

You have the treatment into a vein, usually as an injection but sometimes as a drip (an intravenous infusion). Depending on your condition and how severe it is, you may have factor concentrates to try to prevent bleeding (prophylactic treatment) or only after you have had a bleed.

Factors I, VII, VIII, IX, X, XI and XIII are available as replacement factors for bleeding disorders. They can all be made from human blood plasma – the straw-coloured liquid that carries the blood cells. The plasma is treated during the process to make sure it does not carry HIV or hepatitis.

For bleeding disorders involving factors VII, VIII, IX and XIII there are man-made factor (‘recombinant’) concentrates available. These are made in a laboratory.

There is another factor replacement treatment called prothrombin complex concentrate (PCC). This is also made from human plasma and contains a mixture of factors II, VII, IX and X, although not all PCC products contain all of these. It is used to treat deficiencies of factors II and X, and inherited combined deficiency of vitamin K dependent factors (VKCFD).

Fresh frozen plasma
You may have treatment with human plasma if there is no factor concentrate available for your condition. You have the treatment through a drip into a vein. It frequently used as treatment for factor V deficiency.

Cryoprecipitate 
This is made from blood plasma. It contains factor I, factor VIII, VWF and FXIII that are important for blood clotting. You have the treatment through a drip into a vein. It is more concentrated than FFP, so you have a smaller volume through the drip.

Desmopressin
Also known as DDAVP, this is a manufactured hormone that boosts factor VIII and VWF levels in people with mild haemophilia, some forms of VWD and will raise FVIII in combined factor V and VIII deficiency (F5F8). There are several ways of having the treatment – either as an injection under the skin or into a vein, or through a nasal spray.

Tranexamic acid (Cyklokapron)
This drug helps to stop clots from breaking down. It is useful if you need to have a tooth out, before planned surgery or if you have nosebleeds or heavy periods. It can be used alongside factor replacement for other bleeding symptoms. It comes either as a tablet or liquid that you swallow or as an injection.

Fibrin glue
You have this to treat an injury, rather than your condition. It is mostly used if you have bleeding after dental work or have a cut or wound. Your doctor or dentist will apply it directly to the bleeding site.

Platelet transfusions 
You may have this if you have factor V deficiency or have a platelet disorder. Platelets are small blood cells that are important for clotting. They contain tiny sacs with factor V inside. You have the treatment through a drip into a vein. It looks very much like blood plasma.

Vitamin K treatmentThis is a treatment for some forms of inherited combined deficiency of vitamin K dependent factors (VKCFD). You may have it if you have a bleed or need surgery. It comes as an injection or in a tablet. If it doesn’t help you will need factor replacement treatment.

Hormone contraceptive
This means the birth control pill. Any woman with a bleeding disorder can take this to help control heavy periods.