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Symptoms of a bleeding disorder

The symptoms will vary, depending on the exact type of bleeding disorder you have. But there are some symptoms that are common to all of them. You may: 

  • bruise easily 
  • have heavy, painful periods lasting longer than a week

There are other symptoms that don’t happen in all bleeding disorders but can in most. You may have bleeding:

  • into joints
  • into muscles
  • for longer than normal after minor or major surgery
  • after dental work

Recognising the signs of a bleed

Whether you have a severe or mild bleeding disorder, it is important that you know the signs of a bleed so you can spot it quickly, get appropriate treatment and minimise any complications. People with mild bleeding disorders may be more at risk of missing a bleed as they won’t be so used to the signs.

Some bleeds are more obvious than others, of course. Nosebleeds, bleeding from the gums, heavy periods or bright red blood in the urine are all easy to spot. But other types of bleeding may be more difficult.

Joint bleeds
Bleeds are most common in the elbows, knees and ankles, but they can happen anywhere so look out for signs if you’ve had a blow or sprain. The signs are pain, swelling, and stiffness. The joint may feel warm or hot. An early sign can be tingling or a bubbling feeling inside the joint. A bleed into a joint can cause permanent damage if not treated so do contact your haemophilia team.

Muscle bleeds
This may happen if you have had a blow or a sprain. The muscle may feel tight, hot or stiff. You may have trouble moving an arm or leg. More serious signs are pins and needles, tingling, a change of colour in the skin over the muscle or swollen veins. Contact your haemophilia team straight away if you have any of these.

Gastrointestinal bleeding
This is not common but can be serious if it happens. You may have abdominal or stomach pain, feel faint, clammy or look pale. Signs of a gastrointestinal bleed include black, tarry bowel movements or passing fresh blood. Signs of a stomach bleed include vomiting blood or vomit that looks like coffee grounds. Contact your haemophilia team immediately if you see this.

Blood in the urine or kidney bleeds
Bright blood in the urine is easy to see. But a more minor bleed may cause the urine to look pinkish or dark brown. A kidney bleed may cause low back pain; contact your haemophilia team for advice.

Bleeding inside the skull
This can happen after a blow to the head or for no obvious reason. You may have a bad or worsening headache (for more than 24 hours), feel or be sick, become confused, drowsy or sluggish, have slurred speech, stiffness in your neck or muscle weakness. You may also be unable to bear bright light or have double or blurred vision. This is a medical emergency – contact your haemophilia team immediately if you have a head injury.

Bleeding into the eye
This may be a result of a blow or injury near the eye. The area may swell, be painful, or change colour. You may have double vision, blurred vision or see spots. An ice pack may slow the bleeding, but you should still contact your haemophilia team.

Bleeding between periods
Women may have a small amount of internal bleeding when they release an egg (ovulate) between periods. A niggling pain on one side, low down in the abdomen is normal. But if pain becomes severe or you feel faint or dizzy, contact your haemophilia team. You may have a bleed into a cyst in your ovary.

Heavy periods
Girls often have heavy periods when they reach puberty. However, women with bleeding disorders can have periods that are heavier or last longer than ‘normal’. Anything more than 7 days is NOT usual. You should keep a diary and discuss with your haemophilia team especially if this is affecting your lifestyle or you are very tired.