In recent years, the treatment of haemophilia has become an increasingly multidisciplinary field, in other words, one that is managed by a number of professionals who combine their skills to tackle the disease from different perspectives. Orthopaedists, physiotherapists, dentists and immunologists are just some of the practitioners who now regularly work alongside haematologists, i.e. specialists in blood disorders, to manage the general health of patients with haemophilia.
For women suffering from coagulation disorders, such as haemophilia, however, it is essential for another specialist to be actively involved: the gynaecologist. During their lifetime, women are exposed to a far higher risk of bleeding than men, due to a number of conditions that affect reproductive health. In addition to physiological circumstances such as the menstrual cycle, pregnancy and childbirth, which undoubtedly require specific precautions, certain diseases of the female reproductive system are associated with a high bleeding rate. These include endometriosis and haemorrhagic cysts, which mainly affect women of childbearing potential, as well as fibroids, polyps and endometrial hyperplasia, which are more common during the menopause. In some cases, women with haemophilia can produce extremely low levels of factor VIII, comparable to those of men with the disease, and are therefore exposed to a high risk of bleeding. Women with haemophilia should therefore always inform their gynaecologist, who will take the relevant precautions to prevent any conditions that may pose a threat to their health, if necessary by joining forces with the local Haemophilia Centre.
Kadir R.A. et al. Obstetrics and Gynecology: Hemophilia. Textbook of Hemophilia, 2014. Chapter 46:335-344