The Interplay of Von Willebrand Disease and Women's Reproductive Health

Von Willebrand Disease (VWD) is the most common inherited bleeding disorder and is often diagnosed in the setting of heavy menstrual bleeding (HMB). Because estrogen upregulates von Willebrand factor synthesis, pregnancy and the management of menses may influence VWD testing and diagnosis. Throughout the lifespan, the management of women's reproductive health is frequently impacted by VWD. We seek to describe the interplay between VWD and women's reproductive health at three distinct phases in life: menarche and menstruation, maternal health and fertility, and menopause and aging. Planning for care requires screening for VWD in the setting of reproductive bleeding counseling patients about expectations, and monitoring for iron deficiency across all three phases. Hemostatic plans should be tailored to both factor levels and patient preference. Emphasis is placed on areas lacking vital data.