von willebrand disease foods to avoid
Although several screening questionnaires exist to help identify women with heavy menstrual bleeding who need further hemostatic evaluation, the screening tool in Box 2 may be more appropriate for adolescent patients. How is Antiphospholipid Antibody Syndrome Diagnosed? . These guidelines for diagnosis and management of von Willebrand disease (VWD) were developed for practicing primary care and specialist cliniciansincluding family physicians, internists, obstetrician-gynecologists, pediatricians, and nurse-practitionersas well as hematologists and laboratory medicine . Reaffirmed 2021). Source: National Heart, Lung, and Blood Institute, National Institutes of Health. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Am J Obstet Gynecol 2009;201:12.e112.e8. Make a donation. Combining iron-rich foods with good . Mild forms of von Willebrand disease may . Gradual changes in eating habits can lead to long-term positive results. This content does not have an Arabic version. Rick ME. A nosebleed can be caused by a broken bone, or just a simple cut. In fact, the link may not be due to a nosebleed at all. Type 1. Dogs with vWD may show signs of bleeding, such as skin bruising, bleeding from the gums or nose . Choosing good fats more often than bad fats such as those derived from olive or canola oils. Blood Advances. Rick ME. It does not provide medical advice, diagnosis or treatment. Have you had unexpected bruising? Recombinant factor VIII and vWF complex infusion are plasma-derived concentrates used to replace factor VIII and vWF, respectively. J Obstet Gynaecol Can 2009;31:3407. What Is Von Willebrand Disease? A broad range of values characterizes plasma VWF levels, which average around 10 g/mL. You still have small amounts of VWF in your body to help clot . Von Willebrand disease is a bleeding disorder. What Are the Signs and Symptoms of Hemolytic Anemia? Hemophilia News Today is strictly a news and information website about the disease. Drug Saf 2008;31:27582. By reading this page you agree to ACOG's Terms and Conditions. The effect of ABO blood group on the diagnosis of von Willebrand disease. You will be subject to the destination website's privacy policy when you follow the link. A study published in the Journal of the American Medical Association found that the risk for a person to have the disease increased six-fold if they had a stroke caused by a nosebleed. Von Willebrand disease is a bleeding disorder that slows the blood clotting process, causing prolonged bleeding after an injury. From the National Heart Lung and Blood Institute, National Institutes of Health. VON WILLEBRAND DISEASE, TYPE II B. Von Willebrand disease: Treatment of major bleeding and major surgery . People with bleeding disorders need to maintain normal blood volume and blood cell production. Suite 700 However, if your doctor suspects you have a bleeding disorder, he or she might refer you to a blood disorders specialist (hematologist). J Thromb Haemost 2007;5:11659. VWD is an inherited bleeding disorder where the body doesn't produce enough (or in some cases produces faulty) von Willebrand's factor, an essential blood protein for clotting. Recent guidelines on VWD have recommended taking a VWF level of 30 or 40 IU/dL as a cutoff for those diagnosed with the . People with VWD either have a low level of VWF in their blood or the VWF protein doesn't work . They help us to know which pages are the most and least popular and see how visitors move around the site. Screening and Prevention of Pulmonary Embolism ? Obesity is a worseningproblem in the hemophilia patient community, as it is in the population at large, with obesity rates tripling from 1980 to 2008 among all children, according to the Centers for Disease Control and Prevention. Signs, Symptoms, and Complications of Deep Vein Thrombosis? https://www.cdc.gov/ncbddd/vwd/facts.html. [, Kouides PA, Phatak PD, Burkart P, Braggins C, Cox C, Bernstein Z, et al. Committee Opinion No. Do you have flooding? 1: Iron-rich food. Foods to Avoid with Hemophilia. Individuals who live with a rare disease can face challenges that can be overwhelming. Have you ever needed medical attention for bleeding during or after surgery, dental procedures, childbirth or injury? Box 1 includes a screening tool to help clinicians identify adult patients who may benefit from laboratory testing for disorders of hemostasis. . Levels of von Willebrand factor are lower than normal and levels of factor 8 (another type of clotting factor in the blood) also may be reduced. For example, avoid over-the-counter medicines that can affect blood clotting, such as aspirin, ibuprofen, and other nonsteroidal anti-inflammatory drugs (NSAIDs). What are the Risk Factors with Thrombotic Thrombocytopenic Purpura? Once estrogen levels begin to decrease in the postpartum period, some individuals with bleeding conditions may present with delayed hemorrhage. Use of progestin-only contraceptives, such as medroxyprogesterone acetate; progestin-only pills; and the progestin implant, also may reduce menstrual flow in the setting of bleeding disorders 20 21. Many people with von Willebrand disease also have low levels of factor VIII, another protein that helps in clotting. Von Willebrand disease (VWD), a congenital bleeding disorder caused by deficient or defective plasma von Willebrand factor (VWF), may only become apparent on hemostatic challenge, and bleeding history may become more apparent with increasing age. [, Dilley A, Drews C, Miller C, Lally C, Austin H, Ramaswamy D, et al. Adolescents may have both immaturity of the hypothalamicpituitary axis and heavy menses, further complicating the presentation. Details on the evaluation and management of women who present with abnormal uterine bleeding are addressed in other publications from the American College of Obstetricians and Gynecologists (the College) 8 9. Clinical characteristics: Von Willebrand disease (VWD), a congenital bleeding disorder caused by deficient or defective plasma von Willebrand factor (VWF), may only become apparent on hemostatic challenge, and bleeding history may become more apparent with increasing age. Obstet Gynecol 2013;122:17685. This interferes with the clotting process and can sometimes cause uncontrolled bleeding. National Hemophilia Foundation. A protein called von Willebrand factor helps blood clot. Have you ever felt a lump under the bruise? Von Willebrand disease: Treatment of major bleeding and major surgery. Obstetriciangynecologists should include von Willebrand disease and other bleeding disorders in the differential diagnosis when evaluating patients with heavy menstrual bleeding, regardless of age. Rick ME. Boil a handful of crushed fenugreek seeds in water for a couple of minutes before straining the liquid and applying it to your skin using a cotton pad or sponge. Make a donation. If your child has VWD that's severe enough to cause bleeding, anyone who cares for him or her should be told about the condition. If you carry the gene for von Willebrand disease, you can pass it on to your offspring, even if you don't have symptoms. Calcium is also an important nutrient for your teeth. Whether obesity among hemophilia patients is on par with the population or above the national norm, excessive weight puts strains on joints that can lead to bleeds, and these patients need to pay extra attention to their diet and try tomaintain a healthy weight. von Willebrand disease overview. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. What are the possible side effects of the medications you're prescribing? Additional symptoms or signs that may be present include epistaxis (3863%), gingival bleeding (2635%), bleeding after dental extraction (2952%), bleeding from minor cuts or abrasions (36%), postoperative bleeding (2028%), gastrointestinal bleeding (14%), and joint bleeding (68%) 6 7. There are many treatment options available for patients with von Willebrand disease and heavy menstrual bleeding, including hormonal and nonhormonal therapies. If screening results are positive, laboratory evaluation is indicated Figure 1. Limited studies have been conducted on the treatment of heavy menstrual bleeding specifically for women with von Willebrand disease or other disorders of hemostasis; the following treatments are based on this evidence and expert opinion. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. This document reflects emerging clinical and scientific advances as of the date issued and is subject to change. Who is at Risk of Iron-Deficiency Anemia? What are the Signs and Symptoms of Aplastic Anemia? Cochrane Database of Systematic Reviews 2000, Issue 4. See your health care professional if you or someone in your family has these symptoms. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Levonorgestrel-releasing intrauterine system compared to low dose combined oral contraceptive pills for idiopathic menorrhagia: a randomized clinical trial [published erratum appears in Contraception 2011;84:112]. The condition appears in many breeds of dogs, but it . Its one of the most common types of hemorrhagic stroke, and it can be deadly. A hematologist is a doctor who specializes in diagnosing and treating blood disorders. Von Willebrand disease: Treatment of major bleeding and major surgery. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Bleeding events and other complications during pregnancy and childbirth in women with von Willebrand disease. What are the Signs and Symptoms of Antiphospholipid Antibody Syndrome? Iron-rich foods include liver, lean red meat, poultry, leafy green vegetables such as spinach, broccoli, dried beans, grains, and raisins. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. A benefit-risk review of systemic haemostatic agents: part 2: in excessive or heavy menstrual bleeding. https://rarediseases.org/rare-diseases/von-willebrand-disease/. For example, the school nurse, teacher, daycare provider, coach, or any leader of afterschool activities should know, especially if your child has severe VWD. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). If you are considering dietary supplements, discuss your choices with your doctor before taking any supplements, as some might increase bleeding tendency or clotting times in the same way as aspirin or non-steroidal anti-inflammatories. Another replacement therapy approved by the Food and Drug Administration for treating adults 18 and . The platelet function analyzer-100 closure time can be a useful adjunct in screening for disorders of platelet aggregation, but it lacks sensitivity and specificity to be used alone as a screening test 13. How frequently do you need to change your pad or tampon? [, Lukes AS, Moore KA, Muse KN, Gersten JK, Hecht BR, Edlund M, et al. Avoid high-fat condiments like mayonnaise or ketchup choose mustard instead, which is low in calories; Choose salad dressing on the side this way you can control the amount you use. [, Kouides PA, Byams VR, Philipp CS, Stein SF, Heit JA, Lukes AS, et al. Theoretically, tranexamic acid also should work in women with von Willebrand disease because it stabilizes clots that have already formed, and clot formation is an essential step in limiting menstrual bleeding. Available at: Kingman CE, Kadir RA, Lee CA, Economides DL. Br J Haematol 2009;145:21220. Am J Obstet Gynecol 2008;198:163.e1163.e8. Thank you for taking the time to confirm your preferences. You might need to follow dietary restrictions or fast for 8-10 hours if blood tests are scheduled. It can be inherited or, less commonly, develop later in life (this type of VWD is not heritable and is referred to as acquired von Willebrand syndrome [AVWS]). If you have von Willebrand disease (VWD), you can take steps to prevent bleeding and stay healthy. 2006;108(10):3344-3351. In adolescents, fertility preservation is paramount; therefore, medical options should be used rather than surgical procedures. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Football, hockey, wrestling, and lifting heavy weights are not safe activities if you have bleeding problems. It also helps prevent damage to muscles and joints. The Full Report provides information on the causes, diagnosis and treatment of VWD. Von Willebrand disease. Data from Philipp CS, Faiz A, Dowling NF, Beckman M, Owens S, Ayers C, et al. Desmopressin acetate is a synthetic derivative of the antidiuretic hormone vasopressin and works by stimulating the release of vWF from endothelial cells 7. Blood Advances. Acquired and inherited factors both modulate plasma VWF levels, and twin studies have demonstrated that 66% of all variations in plasma VWF are genetically determined, while 30% of them depend on ABO blood group, 7 O blood group individuals having plasma VWF levels 25% lower than non-O subjects. Rick ME. Type 1 is the most common type of von Willebrand disease. Many people with von Willebrand disease don't know it because the signs are mild or absent. Blood. . Von Willebrand disease, sometimes referred to as vWD, is the most common inherited blood disorder in dogs and in humans, for that matter. Thyroid hormones if thyroid dysfunction is found to be a causative factor. In case of an accident or emergency, this will be very helpful to the health care team treating you. If you have von Willebrand disease, your doctor might suggest that family members undergo tests to determine if this condition runs in your family. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Assay of the von Willebrand factor (VWF) propeptide to identify patients with type 1 von Willebrand disease with decreased VWF survival. Have you seen blood clots in your menstrual flow? Retrieved August 9, 2013. These cookies may also be used for advertising purposes by these third parties. Connell NT, et al. What Causes Thrombotic Thrombocytopenic Purpura? If you have von Willebrand disease, you might have: Menstrual signs and symptoms might include: Contact your doctor if you have bleeding that lasts a long time or is hard to stop. Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition. Von Willebrand disease. American College of Obstetricians and Gynecologists [, Dumont T, Allen L, Kives S. Can von Willebrand disease be investigated on combined hormonal contraceptives? Collaboration with a hematologist is recommended to aid in the planning for delivery because of the risk of hemorrhage. Normally, pieces of blood cells (platelets) clump together after an injury. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. 557. Bleeding disorders (including hemophilia) are rare. With these steps for safety, most women who have VWD can have successful pregnancies. How is Disseminated Intravascular Coagulation Treated? Haemophilia 2005;11:497503. Von Willebrand factor helps blood cells stick together (clot) when you bleed. 128. Among women with heavy menstrual bleeding, von Willebrand disease appears to be more prevalent among Caucasians (15.9%) than African Americans (1.3%) 3 4. Avoid contact sports like football, hockey and wrestling. Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition. If possible, talk with a hematologist and an obstetrician who specializes in high-risk pregnancies before you become pregnant. You also should meet with an anesthesiologist to review your choices for anesthesia (AN-es-THE-ze-ah) and to discuss taking medicine to reduce your bleeding risk. DOI: 10.1002/14651858.CD000249. A link to von willebrand disease foods to avoid is not a nosebleed. Type 1 VWD is most common. Find a doctor Find a doctor Close find a doctor menu Back Find a Doctor. Limit High-fat products. Thromb Haemost 1995;74:78490. Globally, von Willebrand disease affects an estimated 23 to 110 in 1 million people. Among a cohort of 38 women with type 1 von Willebrand disease, retrospective analysis of bleeding symptoms revealed that heavy menstrual bleeding at menarche was the most common initial bleeding symptom, which occurred in 53% of women 33. Type 2 VWD: VWF is often in the low or low . Treatment depends on which type of von Willebrand disease you have and the severity of . von Willebrand disease and other inherited bleeding disorders in women with diagnosed menorrhagia. Bulk pricing was not found for item. Obstet Gynecol 2010;116:86575. If you have a nosebleed, especially within the first few hours after it happens, you should definitely avoid foods like ice cream, fruit, and candies before and during the first 48 hours. We take your privacy seriously. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. Have you had bleeding from a small wound that lasted more than 15 minutes or recurred during the week following the wound? The usual cause of von Willebrand disease is an inherited abnormal gene that controls von Willebrand factor a protein that plays a key role in blood clotting. Mayo Clinic; 2021. The link to von willebrand disease foods to avoid may be a bit more than just a nosebleed. The College recommends that an initial reproductive health visit occur between the ages of 13 years and 15 years, which provides clinicians with an opportunity to inquire about menstrual history and screen for bleeding disorders 8 34. Specific topics addressed in the report include initial screening, diagnosis, and management for patients with the disorder; along with directions for future research and recommendations for training for health professionals. If your condition is mild, your doctor might recommend treatment only when you're having surgery or dental work or when you've had a trauma, such as a car accident. J Pediatr Adolesc Gynecol 2013;26:13841. 5008 Brittonfield ParkwayEast Syracuse, NY 13057, Upstate Community Hospital4900 Broad RoadSyracuse, NY 13215, 37 West Garden StreetSuite 301Auburn, NY 13021, 5700 West Genesee StreetCamillus, NY 13031, Nurse Practitioners & Physician Assistants, Social Security Disability Benefits With Cancer. In von Willebrand disease, there is not . However, vWF and factor VIII levels are important to assess during pregnancy, including in the third trimester to facilitate planning for delivery and in the event of postpartum hemorrhage 12 15. Cookies used to make website functionality more relevant to you. In adult patients, prior bleeding challenges, such as surgery, dental work, or childbirth, are more common. Von Willebrand disease is a lifelong bleeding disorder in which your blood doesn't clot properly. You then might be referred to a doctor who specializes in the diagnosis and treatment of bleeding disorders (hematologist). These test results may be affected by several variables, including stress (eg, surgery, anxiety, or exercise), systemic inflammation or anemia, pregnancy, oral contraceptives, time of the menstrual cycle, sample processing, and the quality of the laboratory 7. Yes, broadly there are three types of von Willebrand disease: Types 1, 2, and 3. Want to talk about Multiple Myeloma: Anyone else? Obstet Gynecol 2010;116:2403. So you might need to repeat some tests. Rarely, von Willebrand disease can cause uncontrollable bleeding, which can be life-threatening. These cells clump together to help stop the bleeding. ASH ISTH NHF WFH 2021 guidelines on the management of von Willebrand disease. [, Ragni MV, Bontempo FA, Hassett AC. Von Willebrand disease. Von Willebrand disease (VWD) is an inherited condition that affects males and females. This helps form a clot and stops bleeding. However, adolescence is a time when bleeding patterns can be highly variable. Overview of bleeding disorders in adolescent females with menorrhagia. Affected women may have heavy menstrual bleeding. The association of von Willebrand disease with other gynecologic problemsincluding ovarian cysts, endometriosis, and leiomyomasis uncertain 1. It is particularly important to diagnose bleeding disorders early in children and adolescents because accidental trauma is the most common source of morbidity and mortality in this age group 7 15. Practice Bulletin No. What Causes Disseminated Intravascular Coagulation? Programs like Choose my Plate can help inadopting a healthy eating style. The stress of keeping up with a busy schedule can easily lead to poor dietary choices, and eating healthy is sometimes easier said than done. Saving Lives, Protecting People, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, U.S. Department of Health & Human Services. https://www.uptodate.com/contents/search. : CD000249. Most people with von Willebrand disease are born with it, but it can also occur later in life. Accessed Aug. 26, 2021. Obtaining a blood specimen for laboratory testing before administering hormonal treatment may be beneficial in some cases. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. [, Shankar M, Lee CA, Sabin CA, Economides DL, Kadir RA. 2 People with a bleeding disorder often experience the effects of obesity immediately, as excess weight can limit joint mobility and may lead to more frequent joint . If you have ever heard of von willebrand disease, it is a disease that affects the blood vessels of the inner lining of the nose. The American Heart Association lists foods that are known to be good for your blood pressure, cholesterol, and general health. Several factors can disrupt any of the four stages of wound healing. The onset of heavy menses at menarche is often the first sign of von Willebrand disease. [, Endrikat J, Shapiro H, Lukkari-Lax E, Kunz M, Schmidt W, Fortier M. A Canadian, multicentre study comparing the efficacy of a levonorgestrel-releasing intrauterine system to an oral contraceptive in women with idiopathic menorrhagia. Patients should be reminded that products that prevent platelet adhesion, such as aspirin or nonsteroidal antiinflammatory drugs, should be avoided once von Willebrand disease is diagnosed 7. Although this tool may be helpful, clinical utility may be limited. Evaluation and management of acute menorrhagia in women with and without underlying bleeding disorders: consensus from an international expert panel. Von Willebrand disease is the most common type of bleeding disorder. Another replacement therapy approved by the Food and Drug Administration for treating adults 18 and older is a genetically engineered (recombinant) von Willebrand factor product. The use of levonorgestrel-releasing intrauterine system for treatment of menorrhagia in women with inherited bleeding disorders. Von Willebrand disease can't be cured. After testing for Hemophilia, adults are advised to shift to natural or organic healthy fat products like nonfat milk or low-fat cheese because these are rich in vitamins, minerals, and calcium. [, Lee CA. Limited studies in women with von Willebrand disease and heavy menstrual bleeding suggest these treatments also may be effective for this population 14 16 19 24. ABSTRACT: Von Willebrand disease, the most common inherited bleeding disorder among American women, is a common cause of heavy menstrual bleeding and other bleeding problems in women and adolescent girls. Always check with your doctor before taking any medicines. Von Willebrand disease: key points from the 2008 National Heart, Lung, and Blood Institute guidelines. American College of Obstetricians and Gynecologists. Full Guidelines pdf icon[2.45 MB / 126 pages]external icon. People with the disease have low levels of von Willebrand factor, a protein that helps blood clot, or the protein doesn't perform as it should. Regardless ofyour hemophilia type A, B or C the goal is to keep your joints strong and healthy, and to keep extra weight off to avoid muscle strains and bleeding in vulnerable joints. have von Willebrand disease. The study found that people who suffered from volebrand disease were more likely to have a stroke at any given time.The studies on volebrand disease foods have been done.A link to von willebrand disease foods to avoid is not a nosebleed. J Pediatr Adolesc Gynecol 2010;23(suppl):S1521. Multisite management study of menorrhagia with abnormal laboratory haemostasis: a prospective crossover study of intranasal desmopressin and oral tranexamic acid. Von Willebrand disease is a blood clotting disorder that usually develops from an inherited genetic condition but can in rare cases develop alongside an autoimmune disease or . Rick ME. An accurate diagnosis is extremely important for women in order to avoid unnecessary and/or invasive treatments, such . What are the Symptoms of Iron Deficiency? Bethesda (MD): NHLBI; 2007. South Med J 2006;99:36670. Accessed Aug. 26, 2021. Have you had anemia or needed a blood transfusion? The main nutrients involved in redblood cell production are iron, protein, copper, vitamin C, vitamin B12, vitamin B6 and folic acid vitamin E is also involved in red blood cell production, but it can increase the risk of bleeding in high doses. Obstet Gynecol 2013;121:8916. Because recombinant factor is made without plasma, it can reduce the risk of a viral infection or allergic reaction. Abbreviations: CBC, complete blood count; FVIII, factor VIII activity; PT, prothrombin time; PTT, partial thromboplastin time; TT, thrombin time; vWF:Ag, von Willebrand factor antigen; vWF:RCo, von Willebrand factor ristocetin cofactor activity. Eur J Obstet Gynecol Reprod Biol 2011;158:12434. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Learn more about how to . If a patient meets one or more of the following criteria, it indicates a positive screen result and warrants further evaluation: Menses greater than 7 days and flooding or gushing sensation or bleeding through pad or tampon in 2 hours, History of bleeding disorder after hemostatic challenge (ie, tooth extraction, surgery, delivery). Agents/circumstances to avoid: Activities involving a high risk of trauma, particularly head . Von Willebrand disease is a bleeding disorder that slows the blood clotting process. Who is at Risk for Disseminated Intravascular Coagulation? Von Willebrand disease in women. Take a family member or friend along, if possible, to help you remember the information you'll be given. . blood in the stool from bleeding into the stomach or intestines. Maintaining iron levels is also particularly important for people with hemophilia, as an estimated 0.75 micrograms of iron is lost with each 15 ml of blood. Universal links (header) myUCLAhealth; School of Medicine; Departments; Community & Equity; News; 310-825-2631. [. 08-5832. The study found that people who suffered from volebrand disease were more likely to have a stroke at any given time. rarely, bleeding into joints or internal organs. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Pensacola, FL 32502 Haemophilia 1999;5:3137. Data from National Heart, Lung, and Blood Institute. Menorrhagia in adolescents with inherited bleeding disorders. The pictorial bleeding assessment is a tool to specifically record the number of pads or tampons used during the menstrual period, how many times there was passage of clots, and the number of flooding accidents. Your dentist . These self-care tips can help you manage your condition: You'll likely see your family doctor if you think you have a bleeding problem. Talk with your health care team before starting any dietary supplement. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. Specific questions can help one gain a better understanding of how heavy an adolescent is bleeding, including the following: How many pads or tampons do you use in a day? Always check with your doctor before starting any exercise program. Antifibrinolytics inhibit the conversion of plasminogen to plasmin, which inhibits fibrinolysis and, thereby, help stabilize clots. [, Shaaban MM, Zakherah MS, El-Nashar SA, Sayed GH. Von Willebrand disease is the most common bleeding disorder, and affects males and females . The term "anesthesia" refers to a loss of feeling and awareness. Von Willebrand disease.