“My menstrual cycle is fine, 7-8 days and sometimes even 10 days, it has always been like this.”
“Whenever they draw blood for blood tests, the bleeding lasts quite a bit.”
When it comes to bleeding, most people think of dramatic injuries or severe conditions like hemophilia. However, there’s another important factor that many of us—especially women—often overlook: Von Willebrand Factor (vWF).
If you have low levels or your vWF isn’t functioning correctly, you might experience prolonged bleeding during your menstrual cycle, unexpected bruising, or excessive bleeding after seemingly minor events like dental extractions.
Surprisingly, many women don’t discover their issue with vWF until facing a significant bleeding challenge, such as childbirth or surgery. Even more subtle cases often go unnoticed, leaving women vulnerable when they least expect it.
This hidden risk isn’t limited to hereditary cases alone—certain health conditions, such as having a mechanical heart valve or disorders like Myeloproliferative Neoplasms (MPNs), can lead to an acquired deficiency of vWF.
Recognising and addressing potential vWF issues early can make all the difference, ensuring safer pregnancies, smoother recoveries from procedures, and overall better quality of life.
Why Should You Care about von Willebrand Disease (VWD)?
Von Willebrand Disease (VWD), the condition resulting from low or dysfunctional von Willebrand Factor, can vary significantly in severity. Many women experience only mild symptoms, which leads them to underestimate or even dismiss their importance. However, these subtle signs are critical red flags that should prompt a discussion with your doctor.
Common Signs to Watch For:
- Prolonged or heavy menstrual bleeding (menorrhagia):
If your periods regularly last more than seven days, or if you find yourself needing to change sanitary products every hour or two, this might be an indicator of VWD. - Excessive bleeding after dental procedures or minor injuries:
Perhaps you’ve noticed bleeding that takes longer than usual to stop after dental work or minor cuts. This is another subtle yet important clue. - Frequent or unexplained bruising:
Easy bruising without a clear cause or larger bruises than expected could indicate your body is struggling with proper clotting.
The Importance of Early Detection:
For young women, especially those considering pregnancy or surgical procedures, understanding your risk is vital. While mild forms of VWD might not significantly disrupt daily life, they can pose serious bleeding risks during childbirth, surgeries, or after dental extractions. Early identification ensures better preparedness, safer pregnancies, and fewer surprises when managing bleeding events.
Moreover, knowing your status allows healthcare providers to tailor interventions, minimizing risks during critical times.
Congenital vs. Acquired von Willebrand Disease
Von Willebrand Disease isn’t always something you’re born with—certain medical conditions can cause your body to lose or develop deficiencies in vWF later in life. Understanding this difference helps clarify when you might need testing:
- Congenital VWD:
This is the inherited form of the disease. Symptoms can be subtle enough to remain unnoticed until a significant event triggers recognition, such as surgery or childbirth. - Acquired VWD:
Some individuals develop vWF deficiency later in life due to underlying medical conditions or procedures, including:- Mechanical heart valves: These artificial valves can lead to increased breakdown of vWF, raising bleeding risks.
- Myeloproliferative Neoplasms (MPNs): Conditions like Essential Thrombocythemia or Polycythemia Vera can result in an acquired vWF deficiency, increasing bleeding tendencies despite high platelet counts.
- Autoimmune conditions and certain cancers: These disorders can similarly disrupt vWF function or reduce levels, further complicating treatment and bleeding risk management.
Recognising that VWD isn’t solely a hereditary concern emphasises the importance of considering vWF testing even if your bleeding problems developed later in life.
Current Clinical Research and Emerging Therapies
Medical science is in the era of exciting advances to improve life for people with von Willebrand Disease. New treatments currently under clinical investigation aim to simplify therapy, reduce bleeding events, and enhance quality of life.
Highlights of New Therapies:
- HMB-002 (Hemab Therapeutics):
A groundbreaking treatment administered through simple subcutaneous injections, HMB-002 is designed to naturally increase von Willebrand Factor (VWF) and Factor VIII levels, reducing bleeding episodes without frequent hospital visits. - VGA039 (Star Therapeutics):
VGA039 is another promising medication currently under study. Early trials show this subcutaneous monoclonal antibody reduces bleeding rates (by 75–88%), offering an effective alternative to more demanding intravenous treatments. - Wilate® (VWF/FVIII Concentrate):
Researchers are actively assessing Wilate®, a human-derived concentrate, for its effectiveness in preventing and controlling bleeding, providing new hope for patients needing reliable and predictable management of VWD. - Von Willebrand Factor in Pregnancy (VIP) Study:
Recognising that pregnancy can amplify bleeding risks in women with VWD, this study seeks to better understand how VWF levels change during pregnancy, helping doctors offer safer, tailored care to expectant mothers.
Personalised Medicine on the Horizon:
Innovative therapies like emicizumab and efanesoctocog alfa (Altuviiio®) are also showing potential. These treatments could provide more personalized care, specifically adapted to each patient’s unique medical profile, while substantially reducing treatment burden.
Beyond novel treatments: Artificial Intelligence (AI) in von Willebrand Disease Care
Artificial Intelligence is transforming the landscape of medical care for VWD. AI-driven technologies are now facilitating faster diagnoses, precise therapies, and highly individualised treatment plans.
How AI is Making a Difference:
- AI-designed peptides:
Cutting-edge research demonstrates that AI can create peptides specifically designed to block abnormal interactions of VWF with platelets, potentially preventing excessive bleeding without impacting normal clotting functions. - Personalized genetic analysis:
By using advanced machine-learning algorithms, AI can rapidly analyse a patient’s genetic and clinical data, helping physicians predict treatment effectiveness, minimize risks, and tailor therapies to each individual’s specific needs. - Improved Drug Development:
AI accelerates the discovery and testing of new treatments by predicting molecular interactions. This reduces research time and quickly brings safer, effective therapies to those who need them most.
Take-Home Messages: Protecting Yourself from Hidden Bleeding Risks
- Don’t Overlook Subtle Signs:
Prolonged menstrual bleeding, excessive bleeding after dental procedures, or unexpected bruising should prompt you to talk with your doctor about von Willebrand Disease (VWD). - Early Testing Matters:
Mild forms of VWD often remain hidden until serious bleeding events occur. Identifying your risk early ensures better management and fewer complications during critical moments, such as childbirth, surgeries, or dental treatments. - Congenital vs. Acquired VWD:
Remember, von Willebrand Factor deficiencies can develop later in life due to conditions like mechanical heart valves or Myeloproliferative Neoplasms (MPNs). This highlights why ongoing awareness of symptoms is crucial, even if you’ve previously tested negative. - Recommendation for Pregnant Women:
Given the risks associated with childbirth-related bleeding, every pregnant woman should ideally undergo vWF testing to assess their bleeding risk. Knowing your status allows your healthcare team to better prepare and minimize potential complications, ensuring a safer pregnancy and delivery experience.
Your Next Step:
If you’ve noticed any signs of prolonged bleeding or are considering pregnancy, talk openly with your doctor about von Willebrand Factor testing. Being proactive now can significantly reduce your risk later, empowering you with the knowledge you need for a safer, healthier life.
Disclaimer:
The information presented in this article is accurate to the best of the author’s knowledge as of the publication date. However, medical knowledge and treatment guidelines are constantly evolving, and new research findings may lead to changes in the information presented here. Readers are encouraged to consult healthcare professionals or refer to the latest guidelines for up-to-date information and personalized medical advice. This article is intended for informational purposes only and is not a substitute for professional medical care.
List of References:
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- Star Therapeutics. (2024). Interim data on investigational VWD therapy VGA039 presented. Available online.
- American Society of Hematology. (2024). A Phase Ia Study of VGA039. Blood. Available online.
- ClinicalTrialsRegister.eu. Ongoing clinical trials on von Willebrand Disease therapies. Available online.
- Washington Center for Bleeding Disorders. (2024). Current trials and studies: Von Willebrand Factor in Pregnancy (VIP) Study. Available online.
- Expert Opinion on Pharmacotherapy. (2024). Emerging therapies in von Willebrand disease treatment. Available online.
- Kazmirchuk T. (2024). Using Artificial Intelligence to disrupt VWF-GPIb interaction. Presented at ISTH 2024 Congress. Available online.
- International Society on Thrombosis and Haemostasis. (2025). Monitoring report on 2021 VWD guidelines. Available online.
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10. Flood, V.H., et al. (2024). Personalized treatment approaches in von Willebrand Disease. Haemophilia. Available online.