title: Medical, reproductive and psychosocial experiences of women diagnosed with von Willebrand's disease receiving care in haemophilia treatment centres: a case-control study.
abstract: OBJECTIVE
  To assess the medical, gynaecological and reproductive experiences of women with von Willebrand's disease (VWD) and to evaluate the impact of VWD on mental health and life activities.
  
  
  METHODS
  A total of 102 women with VWD who were registered in haemophilia treatment Centres (HTCs) in the United States and 88 controls were interviewed regarding medical, gynaecological and reproductive history, life activities and symptoms of depression. Symptoms of depression were measured using the Center for Epidemiological Studies Depression Scale (CES-D).
  
  
  RESULTS
  Excessive bleeding symptoms were reported in 74% of VWD cases compared with 6% of controls. Women with VWD had a higher prevalence of menorrhagia, excessive postpartum bleeding, other gynaecological conditions, arthritis and migraine headaches than did controls. More VWD cases than controls reported that menstruation had a negative impact on overall life activities. No difference in the prevalence of depression was found between cases and controls.
  
  
  CONCLUSIONS
  Women with VWD experience menorrhagia and other gynaecological conditions at a higher frequency than women without bleeding disorders. Menstruation in women with VWD has a negative impact on life activities. The prevalence of depression was not elevated in this group of women whose VWD is being managed in an HTC.
authors.affiliation: Division of AIDS, STD, and TB Laboratory Research, National Center for Infectious Diseases, Centers for Disease Control and Prevention, US Department of Health and Human Services, Atlanta, GA, USA. akirtava@cdc.gov
authors.forename: A
authors.initials: A
authors.lastname: Kirtava
authors.forename: C
authors.initials: C
authors.lastname: Drews
authors.forename: C
authors.initials: C
authors.lastname: Lally
authors.forename: A
authors.initials: A
authors.lastname: Dilley
authors.forename: B
authors.initials: B
authors.lastname: Evatt
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D001168:Arthritis / Q000209:etiology; D001294:Attitude to Health; D016022:Case-Control Studies; D003866:Depressive Disorder / Q000209:etiology; D005260:Female; D006801:Humans; D008595:Menorrhagia / Q000209:etiology*; D008875:Middle Aged; D008881:Migraine Disorders / Q000209:etiology; D006473:Postpartum Hemorrhage / Q000209:etiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D017584:Reproductive History; D014842:von Willebrand Diseases / Q000150:complications* / Q000523:psychology / Q000534:rehabilitation