Haemophilia
Informed by recognized medical guidance
Overview
Haemophilia is a rare inherited bleeding disorder in which the blood does not clot properly because it is missing a specific clotting protein (called a clotting factor). This means a person with haemophilia may bleed for longer after an injury, and can sometimes bleed inside their joints or muscles without a clear cause.
Key facts
- Haemophilia is usually inherited and mostly affects males.
- There are two main types: haemophilia A (missing clotting factor VIII) and haemophilia B (missing clotting factor IX).
- Bleeding often happens inside joints, such as knees, ankles and elbows, which can cause pain and swelling.
- With modern treatment, most people with haemophilia can live active, full lives.
- Treatment involves replacing the missing clotting factor or helping the body use its own clotting factors better.
No, haemophilia is rare. It affects about 1 in 5,000 to 10,000 male births worldwide, with haemophilia A being more common than B.
Haemophilia mainly affects males, because the faulty gene is carried on the X chromosome. Females can carry the gene and may have mild bleeding symptoms, but it is uncommon for them to have severe haemophilia. In rare cases, people develop an acquired form of haemophilia later in life.
Symptoms
- Severe headache, vomiting, confusion, weakness or seizures after a head injury — these can be signs of bleeding inside the brain
- Bleeding in the throat or neck that makes it hard to swallow or breathe
- Bleeding from a major injury that will not stop, even with pressure
- Sudden, severe pain and swelling in a joint after an accident
- ⚠A suspected bleed into a joint or muscle
- ⚠Blood in urine or stool
- ⚠A cut that continues to bleed despite applying firm pressure
- ⚠Any head injury, even if there are no symptoms yet — especially in children
Common symptoms
- Easy bruising, sometimes with hard lumps under the skin
- Prolonged bleeding from cuts, dental work or surgery
- Spontaneous bleeding into joints, causing pain, swelling and stiffness
- Bleeding into muscles, causing deep bruising and swelling
- Blood in the urine or stool
- Frequent nosebleeds that are hard to stop
Symptoms in children
- Excessive bruising when learning to crawl or walk
- Swollen, tender joints without a clear injury
- Prolonged bleeding after losing a baby tooth
- Irritability or crying without an obvious reason, which can signal internal bleeding
- Bleeding after circumcision
Symptoms in older adults
- Joint pain and stiffness from repeated bleeds over many years
- Higher bleeding risk after falls, surgery or when taking certain medicines
- Slower healing of bruises
- Bleeding linked to age-related health conditions, such as stomach problems or prostate issues
Causes
Main causes
- An inherited genetic change on the X chromosome that reduces or stops production of a clotting protein (factor VIII in haemophilia A, factor IX in haemophilia B)
- Rarely, an acquired form develops when the immune system mistakenly attacks the body's own clotting factors
Risk factors
- Having a family history of haemophilia
- Being male, since males have one X chromosome and a single faulty gene causes the condition
- Being older, in the rare acquired form of the condition
When to see a doctor
See a doctor urgently if:
- A suspected bleed into a joint or muscle
- Any head injury, even a mild one
- Bleeding that is difficult to stop
- Blood in the urine or stool
Book a routine appointment if:
- If you or your child bruise easily and bleed a lot
- Before any dental work or surgery, so your care team can plan ahead
- If you are planning a pregnancy and have a family history of haemophilia
- If you are a woman with a family history who wants to know if you carry the gene
Diagnosis
Diagnosis begins with a detailed family history, a physical examination, and blood tests. If haemophilia is suspected, doctors measure how long your blood takes to clot and check the levels of specific clotting factors in your blood.
Tests that may be done
- Complete blood count (CBC) to check the number of blood cells
- Clotting tests, such as prothrombin time (PT) and activated partial thromboplastin time (APTT)
- Clotting factor assays to measure the level of factor VIII and factor IX
- Genetic testing to identify the specific gene change
- Prenatal tests, such as chorionic villus sampling or amniocentesis, if the condition runs in the family
What to expect at your appointment
You will be referred to a haematologist — a doctor specialising in blood disorders — at a specialist haemophilia centre. There, a care team will guide you through testing, treatment and regular follow-up. For babies, a simple blood test can be done shortly after birth if there is a family concern.
Treatment
Treatment aims to prevent and control bleeding, protect the joints, and allow a normal lifestyle. The main approach is to replace the missing clotting factor so the blood can clot properly. For people with frequent bleeds, regular preventive treatment can keep clotting factor levels high enough to avoid bleeds altogether.
Self-care at home
- Apply firm pressure to any cut or nosebleed for 5 to 10 minutes
- Use a soft toothbrush and keep good dental hygiene to avoid gum bleeds
- Avoid contact sports, and wear protective pads and helmets when exercising
- Keep a first-aid kit at home with dressings and bandages
- Carry a medical alert card or wear a bracelet that tells others you have a bleeding disorder
- Always ask your pharmacist or doctor before taking any painkillers, as some can increase bleeding risk
Medical treatments
Medical treatment involves replacing the missing clotting protein by slow injection into a vein, or, for milder forms, using medicines that help the body release its own clotting factors. Some people receive treatment regularly to prevent bleeding, while others treat a bleed only when it happens. Newer longer-acting factor products and other therapies are also available. Your specialist team will tailor the approach to your type and severity of haemophilia, and will train you or your family to give treatment at home when appropriate.
When is surgery considered?
Surgery and dental procedures are safe when planned in advance with your haemophilia team. Extra clotting factor is given before, during and after the procedure to keep your blood able to clot normally while you heal. Always tell your surgeon and dentist that you have haemophilia.
Living with this condition
Living with haemophilia means learning to spot the early signs of bleeding and acting quickly. Most treatment happens at home after training from your specialist team. Regular check-ups at a haemophilia centre help monitor your joints, treatment plan and overall health, so you can adjust your routine as your life changes.
Lifestyle tips
- Exercise regularly to strengthen muscles and protect joints — choose activities like swimming, walking or cycling
- Warm up before exercise and cool down afterwards to reduce strain on your joints
- Avoid high-impact or contact sports such as rugby, boxing or football unless your care team has agreed it is safe for you
- Tell teachers, coaches and employers about your condition so they can help you stay safe
- Keep easy access to your haemophilia centre contact number wherever you go
Diet and exercise
A balanced diet rich in calcium and vitamin D supports bone and joint health, which is especially important because repeated bleeds can stress joints. Regular gentle exercise such as swimming and cycling improves joint stability while being easy on the body. If a joint hurts, rest and contact your care team before returning to activity.
Mental health and emotional wellbeing
Living with a lifelong condition can sometimes feel stressful, isolating or worrying. Anxiety about unexpected bleeds, missing out on school or work, or feeling different from others is normal. It is okay to ask for help — talking to a counsellor, or joining a support group where people understand what you are going through, can make a real difference.
Prevention
The inherited form of haemophilia cannot be prevented, but its complications can. Preventive factor treatment, regular exercise and safety precautions greatly reduce bleeding episodes and joint damage. If you have a family history, genetic counselling can help you understand the risk for future children and explore testing options.
Vaccines
Because treatment can involve blood products, experts recommend keeping vaccinations up to date — especially for hepatitis A, hepatitis B and COVID-19. Some vaccines are given as injections into the skin rather than muscle to reduce bruising and bleeding. Your haemophilia team can advise which vaccines you need and how they should be given.
Screening programmes
If you have a family history of haemophilia, carrier testing and prenatal diagnosis are possible. Female family members can have a blood test to see if they carry the gene, and genetic counselling can help you make informed decisions before and during pregnancy.
Complications
If left untreated
- Permanent joint damage, stiffness and chronic pain from repeated bleeds into the joints
- Bleeding inside the brain, which is rare but life-threatening
- Muscle bleeds that press on nerves and cause weakness, numbness or loss of movement
- Anaemia from significant blood loss
- Development of antibodies (inhibitors) that make treatment less effective over time
Long-term outlook
With modern treatment, most children with haemophilia grow up to live full, active lives with a near-normal life expectancy. The outlook is best when treatment starts early, bleeds are managed promptly, and follow-up care is regular. Research continues to improve treatment options, making daily life easier and reducing long-term complications.
Find support
International organisations
Local organisations
- The Haemophilia Society (UK) ↗ · United Kingdom
External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.
Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
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Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: July 31, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.