Many effective treatments for von Willebrand disease (VWD) are available.
For women with heavy menstrual periods, the combined oral contraceptive pill can be effective. Tranexamic acid (Cyklokapron®) or aminocaproic acid (Amicar®) can also be used for heavy periods, as well as to treat other kinds of bleeding such as nosebleeds or bleeding from the gums either in tablet form, or as a paste or mouthwash. These two treatments can also be used to prevent bleeding during minor procedures or dental work.
Desmopressin (DDAVP) works for most, but not all patients with VWD, and temporarily increases levels of the clotting factor, von Willebrand factor (VWF) and another clotting factor, Factor VIII. It can be used to treat or prevent bleeds, but care must be taken with the amount of fluid a person drinks for 24 hours after it is given because it can cause water intoxication and a low blood sodium level.
In the most severe cases, VWF replacement therapy can be given. In Canada, two VWF concentrates are currently available, Humate-P and Wilate. Both come from blood donors and are safe and effective. A recombinant VWF concentrate (Vonvendi), which does not come from blood donors, will be available in the future.
Gynecologic options include the levonorgestrel intrauterine device (Mirena® or Jaydess®), an endometrial ablation or a hysterectomy.
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Nichols, Haemophilia, 2008.