Bleeding Disorders in the Bedroom: Sex and Hemophilia

Shellye Horowitz avatar

by Shellye Horowitz |

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Intimacy. Warmth. Comfort. Security. Closeness. These are things that many of us yearn for in relationships. However, when someone has a bleeding disorder, relationships can also be associated with other things, like fear, pain, embarrassment, and shame.

Sexuality is hard to discuss, even for people without bleeding disorders. Frank conversations and a willingness to problem-solve are necessary to create healthy sexual practices when someone has a bleeding disorder.

Pain with sex

Before my hysterectomy, intimacy was painful. I would often spot afterward, resulting in emotional ambivalence: I wanted intimacy and closeness, but I did not want the pain and spotting.

I hemorrhaged for weeks after my hysterectomy. I was hesitant to participate in any activity that could cause bleeding. Furthermore, surgical menopause changes a woman’s anatomy. Vaginal dryness can increase pain, and for some, the chance of injury during intimate moments. It is hard to crave sexual closeness that results in injury. Lubricant helps but does not solve the problem.

Pressure on partners

The last thing a partner wants is to inflict harm during times of physical closeness. As a result, partners can also struggle with their feelings toward physical relations. My partner was scared to hurt me and did not want to cause any bleeding. It didn’t seem like intimacy was worth it.

Possible interventions

Couples can experiment expressing their sexuality without penetration, reducing the risk of injury. Doctors can participate in conversations about intimacy and help couples plan for safer interactions. Interventions may involve factor replacement products or desmopressin acetate to provide protection before, during, and after sexual activity.

Setting and respecting boundaries is one way to increase safety in the bedroom. When a person with a bleeding disorder believes they are in a potentially harmful situation, they need to feel they can ask to stop. Their partner must acknowledge and respect this boundary. Discussions may involve choosing a “code word” to let your partner know it is time to stop. Once a safety plan is in place, it must be implemented without judgment. Staying “stop” in the middle of an intense physical connection can be tough, but trusting your partner enough to say “stop” shows the strength of the relationship.

Couples may need to plan for when sex gets “messy.” This might include choosing a location that can be easily cleaned, like a bathtub or shower, or using a thick towel to protect the furniture. The important thing is to find something that works for both partners.

Plans are crucial

Planning for sexual encounters can help a couple feel safe during intimate moments. Intimacy is often a large part of a relationship. Keeping lines of communication open will help build trust and assist people as they seek to keep their relationship strong.


Note: Hemophilia News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Hemophilia News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to hemophilia.


Nawaz khosa avatar

Nawaz khosa

My 16 year daughter with hemophilia b .i am so worry about her .we have no treatment centre no society working how can she manaige there young age it.s quesstion.please help us


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