Do some people with hemophilia bleed more often than others?

Some people with hemophilia have no working factor in their blood. Others with hemophilia have some working factor but not enough to stop all bleeds. Some people bleed every week, some every month, others maybe only once a year. How often a person with hemophilia bleeds depends on how much factor works in the blood. Severe hemophilia means little or no factor works in the blood. Medically it is described as less than 1% active. People with severe hemophilia tend to bleed often, sometimes once or twice a week, even with no known injury! Severe hemophilia is hardly ever fatal, however, in countries like the United States.

Moderate hemophilia means some factor works in the blood. Medically, we say between 1-4% is active. Bleeding occurs usually only after some injury, and maybe only once a month on average.

Mild hemophilia means a lot of factor works in the blood. Medically, we say 5-25% active. Bleeding sometimes doesn't happen even after an injury. Bleeding occurs maybe only a few times a year. People with mild hemophilia need to have factor when having their teeth pulled or when having surgery.

People with severe hemophilia are known to have spontaneous bleed, bleeds that seem to have no cause. Sometimes their factor levels are so low that just normal everyday activities, like walking, running or doing chores, can cause a bleed. Spontaneous bleeds usually occur in places of the body where there is a lot of activity and stress, particularly the joints. Ankles are common sites for bleeds, because ankles bear so much of the body's weight and absorb shocks.

Adapted from Tell Them the Facts! By Laureen A. Kelley, 1995