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. Because estrogen upregulates von Willebrand factor synthesis, pregnancy and management of menses may influence VWD testing and diagnosis. Throughout the life span, the management of women's reproductive health is frequently affected by VWD. We seek to describe the interplay between VWD and women's reproductive health at 3 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 3 phases. Hemostatic plans should be tailored to both factor levels and patient preference. Emphasis is placed on areas lacking vital data.