Underdiagnosis of Von Willebrand Disease: The Silent Majority of Women in Brazil

INTRODUCTION: Von Willebrand disease (VWD) is the most common inherited bleeding disorder. Although autosomal inheritance predicts a similar distribution between sexes, women are more often diagnosed due to hemostatic challenges associated with menstruation and childbirth. AIM: To analyze temporal trends and the demographic profile of VWD in Brazil to support healthcare planning and public health strategies for early detection and multidisciplinary care in women with bleeding disorders. METHODS: This retrospective cross-sectional study analyzed confirmed VWD cases in Brazil registered between 2017 and 2024 in the Hemovida Web Coagulopathies System. Annual case counts, sex distribution, clinical subtypes, and age groups were evaluated using descriptive statistics and linear regression. RESULTS: The number of reported cases of von Willebrand disease rose from 8531 in 2017 to 12,063 in 2024, representing a 41.4% increase. Women constituted most cases throughout the study period. Despite the increasing number of registered cases, the sex proportion remained statistically stable (p > 0.05), indicating a persistent predominance of females. Type 1 was the most prevalent clinical subtype. The demographic profile showed a consistent concentration of registered adults of reproductive age across the entire historical series. The findings suggest persistent underdiagnosis of VWD in Brazil, likely due to structural, socioeconomic, and sociocultural barriers. CONCLUSION: VWD disproportionately affects females in Brazil. Expanding screening strategies, improving access to specialized laboratory testing, and raising awareness may support earlier diagnosis and improved care. Improving epidemiological data and identifying determinants of diagnostic delay may support healthcare planning and the development of public health strategies.