a bruise that is characteristic of hemophilia

Hemophilia Symptoms

There are three main types of hemophilia, a rare blood disorder that affects the blood’s ability to clot. Each type of the condition and its  varies according to what clotting proteins (also called clotting factors) your blood lacks. Symptoms of hemophilia vary depending on the severity of the disorder, which in turn depends on how low your blood’s clotting factor level is. The lower the level, the more severe the condition and symptoms are.

Hemophilia Severity

Normal clotting factor levels range from 50-100%. According to the National Hemophilia Foundation, an estimated breakdown among the overall hemophilia population is as follows:

  • Mild hemophilia occurs in 25% of all cases and is indicated by a clotting factor level of 6-49%.
  • Moderate hemophilia occurs in 15% of all cases and is indicated by a clotting factor level of 1-5%.
  • Severe hemophilia occurs in approximately 60% of cases and is indicated by a clotting factor level of  less than one percent.

Hemophilia Symptoms

According to the Cleveland Clinic, the two most common symptoms of hemophilia are prolonged external bleeding and unwarranted bruising.

Patients with hemophilia can bleed for no apparent reason. This can include frequent nosebleeds or bleeding excessively after simply getting a vaccination. Once external bleeding occurs, it may take longer than normal to stop it, and it can resume after a short while.

Hemophilia can cause excessive bleeding following an injury, dental procedure, or a surgery. This is often when more mild cases become manifest and are diagnosed. Symptoms associated with external bleeding include:

  • bleeding in the mucous membranes, especially the nose and mouth, often for no apparent reason
  • heavy, sustained bleeding from a minor cut or injury
  • bleeding that subsides but then resumes after a short while

Hemophilia also causes internal bleeding in more severe cases. Internal bleeding can be life-threatening. Symptoms associated with internal bleeding are among the following and should be reported to your health care practitioner:

  • blood in the urine or in bowel movements
  • large hematomas, bruises
  • persistent abdominal pain

In severe cases of hemophilia, patients may experience internal bleeding that affects the joints and muscles. Most commonly, bleeding occurs in the knees, elbows, hips, and shoulders. Over time, this bleeding can result in joint damage that causes swelling and debilitating pain in the joints. Joint deformities may also develop. Symptoms of bleeding in the joints include: 

  • joint swelling and stiffening
  • pain, sensitivity to the touch 
  • warmth in affected areas
  • decreased mobility

Another serious complication of severe hemophilia is bleeding in the brain, which may accompany an injury. Seeking emergency medical attention may be necessary if any of the following symptoms occur:

  • long-lasting, painful headaches
  • stiff neck or neck pain
  • mood swings or changes in behavior
  • extreme fatigue
  • changes in vision
  • weakness or loss of balance or coordination

If you have hemophilia, it is recommended that you wear a medical identification bracelet or carry a medical alert card in your wallet. It is a good idea to always inform all of your medical practitioners, including dentists, of your condition. If your child has hemophilia, caregivers and educators should also be informed of warning signs and symptoms.

Last Updated: December 18, 2014