Changes in Treatment During Puberty

Changes in Treatment During Puberty

Talk with your Hemophilia Treatment Center (HTC) team about how puberty will affect your child and his or her bleeding disorder. If you need help talking about sexual health with your child, discuss your options with a member of the HTC team.

During puberty, girls and boys grow at a rapid rate. Because the adequate factor replacement dosage is based on your child's weight, check with your HTC regularly to ensure that your child is getting the appropriate dose.

Heavy Periods

If your daughter has a bleeding disorder with heavy menstrual bleeding, called menorrhagia, her monthly period may be a stressful time and may interrupt her daily activities. She may avoid certain activities and sports for fear of heavy bleeding. She may be embarrassed if her clothes are stained by heavy blood flow.

Here are several steps you and your daughter can take to help relieve the stress of heavy menstrual periods:

• Speak to your daughter's gynecologist or HTC team about the treatments and products available for heavy menstrual bleeding. They may be able to help control her bleeding and alleviate emotional stress, as well.

Here are some treatment options and products that may help:

• When super-absorbent tampons and pantyliners aren't sufficient, light bladder leakage products are ideal for heavy periods. These can be used with super-absorbent tampons. Many brands are very discreet and come in a variety of different absorbencies and sizes for a proper fit.
• Combined oral contraceptives.
• Desmopressin acetate (DDAVP®) injection or nasal spray.
• Antifibrinolytic drugs, which help slow or prevent the breakdown of blood clots. They are either injected or taken orally.
• Factor replacement therapy for more severe bleeding or if your daughter is not responding well to DDAVP®.

Here are some signs and symptoms of anemia:

• Fatigue (very common)
• Weakness (very common)
• Dizziness
• Headache
• Numbness or coldness in your hands and feet
• Low body temperature
• Pale skin (called pallor)
• Rapid or irregular heartbeat
• Shortness of breath
• Chest pain
• Irritability
• Not doing well in school or at work

• If your daughter suffers from menstrual cramps, she should not take over-the-counter medicines that affect blood clotting. These include aspirin, ibuprofen, and some other nonsteroidal anti-inflammatory drugs. Speak with your daughter's doctor about alternative pain medicines.
• Encourage your daughter to exercise—particularly engaging in aerobic exercises, such as brisk walking, swimming, or biking, which all raise the heart rate. These types of exercises help in 2 ways: they release beta-endorphins, the body's own natural pain relievers, and they reduce stress hormones.

• If your daughter feels weak and tired, the doctor can perform a simple blood test to check for anemia. If the body does not have enough iron, it will make fewer red blood cells or red blood cells that are too small. This is called iron deficiency anemia. Iron deficiency anemia is the most common type of anemia in US teens. In women, iron and red blood cells are lost when bleeding occurs from very heavy and long periods, as well as from childbirth. Treatment for anemia may include dietary changes or taking dietary supplements, like vitamins or iron pills.
• If necessary, speak with your daughter's school staff about her bleeding disorder. Educate them on the bleeding disorder and the challenges your daughter may face each month. Request an unrestricted pass to the bathroom for your daughter.