People with hemophilia may bleed anywhere in the body. However, they seldom bleed significantly from small cuts or puncture wounds.
Rather, hemophiliacs bleed more than other people do from significant injuries, trauma or surgery. How badly and how often people bleed directly relates to how much clotting factor they have.
People with hemophilia may experience:
Bleeding into the joints. The joints are the most common place for bleeding to occur. The ankle, knee or elbow joints are most commonly affected. The affected joint becomes warm, painful and swollen. The person is not able to move the joint as freely as before. This can happen after an injury or without any cause.
Bleeding into muscle.
Bleeding into the esophagus, stomach or intestine.
Bleeding into the urine.
Bleeding from the nose and gums.
Heavy menstrual bleeding (in women).
A less common but more serious complication is bleeding into the brain. Symptoms include sudden nausea, headache and decreased mental awareness.
Symptoms of factor XI deficiency usually appear only in people who inherit the disease from both parents. Symptoms can include:
Prolonged and/or excessive bleeding after cuts, surgery or dental extractions
Blood in the urine
Abnormally heavy or prolonged menstrual bleeding
In hemophilia C, bleeding without any cause is rare.