Understanding how bleeds affect life with haemophilia
What you should know about silent bleeds
The information here is not intended as a substitute for medical advice. If you have any concerns or queries regarding haemophilia, please speak to your doctor, pharmacist, or nurse
Haemophilia is a condition where the blood doesn't clot properly, making people with haemophilia more susceptible to bleeding episodes. 1 While some bleeds in haemophilia are visible and easily identifiable, others, called silent bleeds, may not be noticeable right away but can still cause significant damage over time. 2 Understanding these bleeds, particularly silent bleeds in haemophilia, is key to preventing long-term complications and protecting overall health and quality of life. 2
Types of bleeds in haemophilia
Clinical bleeds
Clinical bleeds can be seen and/or felt when they occur. These include bleeds resulting from cuts, scratches, or bruises. 1 Clinical bleeds also include internal bleeds, such as bleeding in the joints, which can be associated with symptoms such as swelling, pain, and stiffness. 1,3
As the symptoms of such bleeds are noticeable, these bleeds can be easier to manage. Immediate treatment with clotting factor replacement therapy can help stop the bleeding, may help prevent further damage or complications, and reduce the impact on everyday life. 1,4
Silent bleeds
Silent (or subclinical) bleeds are small internal bleeds that can happen without pain or obvious symptoms, making them difficult to notice.5 They can occur in different parts of the body, including muscles and joints. Common areas include the knees, elbows, and ankles.1
Impact of silent bleeds
Although they may be easily overlooked, the effects of silent bleeds can build up over time. Repeated bleeding into the same joint can create a cycle of further bleeding and damage.1 This is known as a target joint, and the damage may become permanent.1 Repeated silent bleeds can also lead to pain, stiffness, weakness and reduced movement which can affect everyday activities and overall wellbeing.2
Preventing silent bleeds
Early detection and proactive management
Regular check-ups with your haemophilia care team can help identify signs of bleeding or changes in your joints early, including bleeds that may not be obvious. Your care plan may include monitoring of joints and muscles, as well as imaging scans such as ultrasound or MRI where appropriate.4
Preventative treatment can help reduce the number and severity of bleeds, helping to protect the body from long-term damage.4 There are different approaches to managing haemophilia, so it is important to discuss what may be right for you with your haemophilia care team.
Working together with your care team can help you understand your options and make a plan that supports your individual needs, including protecting your joints, bones and muscles over time.
Click here to download the ‘Silent bleeds’ infographic for more information.
- The Haemophilia Society. Understanding haemophilia booklet. Available at: https://haemophilia.org.uk/wp-content/uploads/2017/04/Understanding_haemophilia_WEB.pdf. Accessed March 2025.
- Gooding R, Thachil J, Alamelu J, Motwani J, Chowdary P. J Blood Med 2021:12:209–220.
- Auerswald G, Dolan G, Duffy A, Hermans C, Jinenez-Yuste V, Ljung R, et al. Blood Coagul Fibrinolysis 2016;7:845–854
- Srivastava A, Santagostino E, Dougall A, Kitchen S, Sutherland M, Pipe SW et al. Haemophilia 2020;26(Suppl 6):1–158.
- Gualtierotti R, Solimeno LP, Peyvandi F. J Thromb Haemost 2021;19(9):2112–2121.
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