Although sexual development follows exactly the same stages in people with or without haemophilia, some men and ‘carrier’ women with haemophilia say that, because they felt ‘different’ from other people at around the time of adolescence, they developed different attitudes towards sex and parenthood.
Bleeding disorders should have no direct effect on sexual activity, although there is a slight risk of developing minor bruising of the genitals in those with severe haemophilia. Occasionally, a psoas (deep hip) muscle bleed may occur that could be linked to sexual activity. This muscle runs from the spine and sweeps forward round the hipbone and down in front of the thigh. Any bleeding here must be treated rigorously with clotting factor replacement therapy to protect the thigh muscle from possible nerve damage.
Adolescents with haemophilia should be actively encouraged to seek advice from their haemophilia centre, GP, or local family planning clinic. Sexual health is just as important for young people with haemophilia as it is for others, and advice should be sought about contraception and ways to reduce the risk of exposure to sexually transmitted diseases such as HIV and chlamydia.