# Do female hemophiliacs menstruate? **URL:** \ **Category:** Factual Questions\ **Created:** [July 25, 1999, 9:12am UTC](https://boards.straightdope.com/t/do-female-hemophiliacs-menstruate/2168 "1999-07-25T09:12:00Z")\ **Posts on this page:** 15\ **Page:** 1
**Author:** ![system](https://global.discourse-cdn.com/straightdope/original/2X/e/e489c3b7d8fce19c4b355dd4fc3f88cc39c34b87.png) [@system](https://boards.straightdope.com/u/system)\ **Post date:** [July 25, 1999, 9:12am UTC](https://boards.straightdope.com/t/do-female-hemophiliacs-menstruate/2168/1 "1999-07-25T09:12:00Z")
How can hemophiliacs menstrate? ---
**Author:** ![system](https://global.discourse-cdn.com/straightdope/original/2X/e/e489c3b7d8fce19c4b355dd4fc3f88cc39c34b87.png) [@system](https://boards.straightdope.com/u/system)\ **Post date:** [July 25, 1999, 9:36am UTC](https://boards.straightdope.com/t/do-female-hemophiliacs-menstruate/2168/2 "1999-07-25T09:36:00Z")
I have a feeling this is probably a troll, but just in case. Hemophilia is rare to the point of virtual nonexistence in women. The one in X-million women who does get it is probably f\*ked, though. * * * Never regret what seemed like a good idea at the time. ---
**Author:** ![system](https://global.discourse-cdn.com/straightdope/original/2X/e/e489c3b7d8fce19c4b355dd4fc3f88cc39c34b87.png) [@system](https://boards.straightdope.com/u/system)\ **Post date:** [July 25, 1999, 9:53am UTC](https://boards.straightdope.com/t/do-female-hemophiliacs-menstruate/2168/3 "1999-07-25T09:53:00Z")
I object, although it is an obvious troll, it still is a legitimate question. Holly? I think this ones got your name all over it. Give em hell. ---
**Author:** ![system](https://global.discourse-cdn.com/straightdope/original/2X/e/e489c3b7d8fce19c4b355dd4fc3f88cc39c34b87.png) [@system](https://boards.straightdope.com/u/system)\ **Post date:** [July 25, 1999, 3:02pm UTC](https://boards.straightdope.com/t/do-female-hemophiliacs-menstruate/2168/4 "1999-07-25T15:02:00Z")
Virtually ALL hemophiliacs are men. Women carry the gene, but it’s almost unheard of for them to be hemophiliacs themselves. I’d have to double-check this with a geneticist to be sure, but I think the only way for a woman to be a hemophiliac would be if a male hemophiliac impregnated a female carrier. Hemophilia is rare to begin with, and that combination of parents is even rarer. ---
**Author:** ![system](https://global.discourse-cdn.com/straightdope/original/2X/e/e489c3b7d8fce19c4b355dd4fc3f88cc39c34b87.png) [@system](https://boards.straightdope.com/u/system)\ **Post date:** [July 25, 1999, 3:36pm UTC](https://boards.straightdope.com/t/do-female-hemophiliacs-menstruate/2168/5 "1999-07-25T15:36:00Z")
One of the Romanov princesses (Anastasia?) was a hemophiliac. Being royalty, her parents were cousins of some sort or other, so she got the gene from both sides of the family. Unless she was an extremely late bloomer, she would have been post-pubescent when she died, so it doesn’t seem to have done her any harm. I’m fairly sure menstruation doesn’t involve any open blood vessels – it’s just a matter of dead tissue sloughing off. But I’m an English major, so you might want to get a second opinion. ---
**Author:** ![system](https://global.discourse-cdn.com/straightdope/original/2X/e/e489c3b7d8fce19c4b355dd4fc3f88cc39c34b87.png) [@system](https://boards.straightdope.com/u/system)\ **Post date:** [July 25, 1999, 3:42pm UTC](https://boards.straightdope.com/t/do-female-hemophiliacs-menstruate/2168/6 "1999-07-25T15:42:00Z")
But menstrual discharge isn’t exactly bleeding, it’s the uteral lining breaking down, if I remember correctly. Probably this process stops when the tissue is gone, and no clotting is involved, so hemophilia wouldn’t make a difference. ---
**Author:** ![system](https://global.discourse-cdn.com/straightdope/original/2X/e/e489c3b7d8fce19c4b355dd4fc3f88cc39c34b87.png) [@system](https://boards.straightdope.com/u/system)\ **Post date:** [July 25, 1999, 6:14pm UTC](https://boards.straightdope.com/t/do-female-hemophiliacs-menstruate/2168/7 "1999-07-25T18:14:00Z")
I’ll tackle the genetics first: Most hemophilia is an X-linked trait. (Sidetrack - there are many different types of clotting deficiencies; the type of hemophilia that was common in the complex intermarrying royal families of Europe was due to deficiency in Factor VIII, which is X-linked.) X-linked traits work like this: Mom is Hh (she has one normal H gene on 1 X-chromosome, and one defective h gene on the other X-chromosome) Dad is H0 (he has 1 nl H gene on his 1 X-chromosome, and no complementary information on his Y chromosome) Each girl they conceive has a 50-50 chance of being HH(normal) or Hh(carrier). Carriers, by the way, do have measureably lower levels of clotting factor, but unless there are other defacts in the clotting system, she has no abnormal bleeding problems). Each boy they conceive has a 50-50 chance of bing H0(normal) or h0(hemophiliac) with abnormal bleeding. For a girl to be hemophiliac, several possibilities exist: 1. Hemophiliac dad & carrier mom would give her 50-50 chance of being Hh(carrier) or hh(Hemophiliac). Unlikely, since most hemophiliacs do not live to reproducing age. 2. Carrier mom + spontaneous mutation in X-chromosome from dad resulting in hh genotype. 3. Carrier mom + inheriting some other clotting deficiency could result in someone who “looked” like she had classic hemophilia, although the genotype would actually be Hh(carrier). PS - to the best of my knowledge, it was only the crown prince (Alexander?) who had hemophilia in the Romanov family. * * * Sue from El Paso [members.aol.com/majormd/index.html](http://members.aol.com/majormd/index.html) ---
**Author:** ![system](https://global.discourse-cdn.com/straightdope/original/2X/e/e489c3b7d8fce19c4b355dd4fc3f88cc39c34b87.png) [@system](https://boards.straightdope.com/u/system)\ **Post date:** [July 25, 1999, 6:26pm UTC](https://boards.straightdope.com/t/do-female-hemophiliacs-menstruate/2168/8 "1999-07-25T18:26:00Z")
Now for the menstrual losses: Menses occur if by ~ 14 days after ovulation, no pregnancy has occurred. The ovary suddenly stops making progesterone (a sex hormone) which is critical for maintaining the thickened uterine lining needed for nurturing a baby. The lining sheds & tears open the supporting arterioles resulting in bleeding. These arterioles constrict & stop bleeding on their own pretty well in most of us. Motrin & similar drugs can help speed this process up. It turns out that the part of the clotting system needed to accomplish all this is not very dependent on factor VIII, or other clotting proteins, but more dependent on platelet function. (Platelets are small non-nucleated blood cells that, when activated, become sticky & stick to the lining of blood vessels & to each other.) Some women with hemophilia do not have uncontrollable hemorrhage with each period. Surviving childbirth would have been exceedingly unlikely, however. * * * Sue from El Paso [members.aol.com/majormd/index.html](http://members.aol.com/majormd/index.html) ---
**Author:** ![system](https://global.discourse-cdn.com/straightdope/original/2X/e/e489c3b7d8fce19c4b355dd4fc3f88cc39c34b87.png) [@system](https://boards.straightdope.com/u/system)\ **Post date:** [July 25, 1999, 8:54pm UTC](https://boards.straightdope.com/t/do-female-hemophiliacs-menstruate/2168/9 "1999-07-25T20:54:00Z")
Looked it up and you’re right about Alexei being the only hemophiliac in the family. In fact there don’t seem to have been any female hemophiliacs among Europe’s royalty – which is exactly where you’d most expect to find them. So never mind … ---
**Author:** ![system](https://global.discourse-cdn.com/straightdope/original/2X/e/e489c3b7d8fce19c4b355dd4fc3f88cc39c34b87.png) [@system](https://boards.straightdope.com/u/system)\ **Post date:** [July 25, 1999, 9:16pm UTC](https://boards.straightdope.com/t/do-female-hemophiliacs-menstruate/2168/10 "1999-07-25T21:16:00Z")
Man, I don’t know what in this question has made me a troll? It seemed like a very legitimate question to me. And I’m dissappointed my initial subject line was changed. I don’t think it was in that bad of taste. Seems like some serious oversensitivity to me. ---
**Author:** ![system](https://global.discourse-cdn.com/straightdope/original/2X/e/e489c3b7d8fce19c4b355dd4fc3f88cc39c34b87.png) [@system](https://boards.straightdope.com/u/system)\ **Post date:** [July 26, 1999, 10:40pm UTC](https://boards.straightdope.com/t/do-female-hemophiliacs-menstruate/2168/11 "1999-07-26T22:40:00Z")
I’d like to state for the record that **Omniscient** is _not_ a troll. I strongly suggest that anyone (esp. a newbie) who is inclined to accuse someone of being a troll do some research on his previous posts first. Regarding your question, given the rarity of a hemophiliac being female and **majormd** ’s statement: > [@](#): > > …most hemophiliacs do not live to reproducing age. I wonder if there’s actually enough data to answer your question without involving any sort of speculation. Sorry I couldn’t help more there. ---
**Author:** ![system](https://global.discourse-cdn.com/straightdope/original/2X/e/e489c3b7d8fce19c4b355dd4fc3f88cc39c34b87.png) [@system](https://boards.straightdope.com/u/system)\ **Post date:** [July 26, 1999, 10:48pm UTC](https://boards.straightdope.com/t/do-female-hemophiliacs-menstruate/2168/12 "1999-07-26T22:48:00Z")
FWIW, it was the initial subject line that made it look like a troll. * * * Never regret what seemed like a good idea at the time. ---
**Author:** ![system](https://global.discourse-cdn.com/straightdope/original/2X/e/e489c3b7d8fce19c4b355dd4fc3f88cc39c34b87.png) [@system](https://boards.straightdope.com/u/system)\ **Post date:** [July 27, 1999, 12:01am UTC](https://boards.straightdope.com/t/do-female-hemophiliacs-menstruate/2168/13 "1999-07-27T00:01:00Z")
Hmmm…the OP didn’t look like a troll to me. Besides the fact that the question itself looked quite legitimate IMHO, I also know from reading this message board that the OPer on this thread does not engage in trolling. Hence the _research_ suggestion. ---
**Author:** ![system](https://global.discourse-cdn.com/straightdope/original/2X/e/e489c3b7d8fce19c4b355dd4fc3f88cc39c34b87.png) [@system](https://boards.straightdope.com/u/system)\ **Post date:** [July 27, 1999, 1:03am UTC](https://boards.straightdope.com/t/do-female-hemophiliacs-menstruate/2168/14 "1999-07-27T01:03:00Z")
I prefer the new topic line for the sole reason that it’s more descriptive. Humor is good, but I’d prefer to know what the thread is about without having to load the whole damn thing. Some of us _are_ still using modems, and it can take some time. ---
**Author:** ![system](https://global.discourse-cdn.com/straightdope/original/2X/e/e489c3b7d8fce19c4b355dd4fc3f88cc39c34b87.png) [@system](https://boards.straightdope.com/u/system)\ **Post date:** [July 27, 1999, 8:41am UTC](https://boards.straightdope.com/t/do-female-hemophiliacs-menstruate/2168/15 "1999-07-27T08:41:00Z")
[Omnicent quote] Man, I don’t know what in this question has made me a troll? It seemed like a very legitimate question to me. My appoligies for seconding the notion of your trolldom. It was a beer addled attempt at sattire that oviously did not read the way I intended. For the record I have read many of Your replies and threads and have always been impressed by the thoughtfullness of the writing.