Dating is always fraught with anxiety. For women with bleeding disorders, the nervousness is compounded by the inevitability of “The Talk.”
Sooner or later, your significant other has to be clued in about the bleeding disorder. But what exactly do you say? How much do you say? Perhaps most important, when is the right time to broach the subject? Here's how to tell your boyfriend about von Willebrand disease.
Sex and intimacy are “difficult issues for women and health providers to discuss,” says Dawn von Mayrhauser, MSW, social worker at the University of Connecticut Hemostasis and Thrombosis Center in Farmington.
“Most women with von Willebrand disease are struggling with these issues,” she says. “They affect marriages, relationships and sexuality.”
There are no hard-and-fast absolute rules for how to discuss bleeding disorders with a prospective mate. If you’re not quite ready to talk, at least wearing or carrying MedicAlert identification would notify a friend or medical personnel of your condition in the event of an emergency.
When you are ready to talk, health professionals—and women who have been there—offer advice to make things go more smoothly.
[Steps for Living: Dating When You Have a Bleeding Disorder]
The Right Time
When is the right moment to mention that you have a bleeding disorder? The first date is probably not the right time. “Some women want to tell right away so there aren’t any secrets,” says von Mayrhauser. “Others want to wait until they’re sure the relationship is going somewhere. Some women—and men—have found that when they reveal too much too soon, it’s the end of the relationship.”
Mentioning that you have a bleeding disorder can be difficult to casually slip into a conversation. Many women don’t say anything until it is likely that a relationship becomes sexual.
[Steps for Living: Sex and Your Bleeding Disorder]
“I wouldn’t broach anything intimate until things started to get real serious,” says Nancy Burks, 37, a widowed mother of two who home schools in Spokane, Washington.
Certainly, the bleeding disorder has to be discussed before a couple has sex. “You can have intercourse and bleed all over the poor guy,” says Burks. “It can be messy.”
Partners may need to be reassured that intercourse isn’t hurting you. “You need to let the guys know that they won’t catch it, and they won’t hurt you,” says Burks.
Many women wait to discuss this issue until a relationship is clearly headed toward matrimony.
“This is an issue that girls are concerned with,” says Debbie Campeau, executive director of Inland Empire Bleeding Disorder in West Richland, Washington, a chapter of the National Hemophilia Foundation, which conducts semi-annual retreats for women. “Most of them don’t say anything. They’ll wait until it’s somebody they’re going to marry.”
Reactions from men can be all over the map. Some men are understanding and accepting, while others respond less graciously and split. “When the response is positive, it can create a strong bond,” says von Mayrhauser.
Some men are concerned about the impact of a genetic bleeding disorder on the heredity of their children.
“The inheritance issue is very important,” says von Mayrhauser.
Despite the risk of rejection, withholding information about a bleeding disorder can cause more problems than it solves.
“For girls who don’t talk about their heavy periods, they may be misunderstood by their significant others,” says Ruth Ann Kirschman, RN, of Mountain States Regional Hemophilia Center in Denver. “The emotional distance may be interpreted as rejection. Honesty is always better.”
Kirschman suggests that couples speak with a nurse or social worker at the hemophilia treatment center (HTC) for answers to questions.
“The HTC is always open for education sessions,” she says. “If a woman with a bleeding disorder is in a serious relationship, we try to include the boyfriend, too.”
If a woman with a bleeding disorder doesn’t bring up the topic, the HTC team should. “It’s very helpful for the social worker on the team to bring these issues up with women, because they’re reluctant to talk about them,” says von Mayrhauser.
[Steps for Living: Bleeding Disorders in Women]