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Excessive or abnormal vaginal bleeding are the most common symptoms when women present to a gynaecologist. Undiagnosed bleeding disorders, especially Von Willebrand's disorder, can be the under-lying cause of menorrhagia in a significant proportion of women. This chapter aims to increase awareness and provide basic information about these relatively uncommon disorders. Immune idiopathic thrombocytopenic purpura (lTP) in adults is usually a chronic disorder with an insidious onset of minor bleeding symptoms. Menorrhagia and dysmenorrhoea adversely affect women's quality of life and may have a major influence on lifestyle and employment. DDAVP (1-desamino-8-D-arginine vasopressin) nasal spray increases von Willebrand factor (VWF) and FVIII and can be used as a home treatment for some women with bleeding disorders. Increased awareness among clinicians of these problems and the treatment options available are essential to improve quality of life and avoid unnecessary surgical intervention.
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