Having a bleeding disorder means you need to pay closer attention to your lifestyle and self-care as you grow older. “We want you to live well as you age,” says Tammuella Chrisentery Singleton, MD, a hematologist at the Louisiana Center for Bleeding and Clotting Disorders at Tulane University School of Medicine who is passionate about women and girls with bleeding disorders. “It’s especially important to be informed and aware of additional complications to make good decisions.”
While there hasn’t been ample research focused on how aging affects women with bleeding disorders, Singleton says it’s good news that the issue is a matter of discussion today. “Ten years ago, we didn’t have this topic,” she says. And she expects the conversations to push researchers to address the issue. “I think we will see a paradigm shift. Hematologists and gynecologists are coming together to look specifically at women with bleeding disorders.”
Three common issues facing women with bleeding disorders.
Menopause and bleeding disorders
Singleton suggests talking with your gynecologist and hematologist about options to make the transition through menopause smoother. After an overall health evaluation, hormone therapy or birth control pills might be considerations, she adds. “It’s a different conversation than for a woman who doesn’t have a bleeding disorder,” Singleton says.
It’s also important to continue to see a gynecologist even when menses ends, says Jeanette Cesta, 54, a national bleeding disorders educator who has von Willebrand disease. “Just because monthly menstrual bleeding is no longer an issue, we need to remember there are other reasons to see a gynecologist regularly,” Cesta says. “Pap smears, mammograms and other gynecological health monitoring is still critical and shouldn’t be ignored.”
Concerns about osteoporosis
Loss of bone density and increased risk of fractures are a concern for all women as they age. However, there is an additional risk for women with bleeding disorders if surgery is necessary as a result of a fracture, says Singleton.
Typically, preventive measures include weight-bearing exercises, spending time outdoors in sunshine and taking oral vitamin D supplements. However, it’s important to talk with your doctor before you take any supplements, as they may affect your bleeding disorder.
Along with regular exercise and eating a well-balanced diet, a positive mental outlook is critical. “I believe attitude has a major impact on our health,” says Cesta. “By continuing to work toward personal goals and being supportive to the people in our lives, we will thrive.”
Questions remain regarding typical recommendations for aging women and how they might affect those with bleeding disorders. For example, “natural remedies such as antioxidants might be heart-healthy for others, but will they interfere with bleeding or platelets?” says Cesta.
Despite such lingering uncertainties, Cesta says she is encouraged by the progress so far. “I love watching the next generations of women coming up and seeing them have better-quality healthcare for their bleeding disorder,” she says. And alongside hope for the next generation is an admiration for her own. “I feel pride for my generation of women, who have endured so many challenges yet have succeeded in lighting the path for women coming behind them.”
• For more information about bleeding disorders in women, visit Steps for Living