Key takeaways
If you are living with hemophilia in your 40s, 50s, or beyond, you're part of a generation doing something that was far less common in the past: growing older with the condition. Many adults today have managed hemophilia for decades, adapting to changes in treatment, care, and everyday life along the way.
You know your symptoms and what works for you, but aging brings new questions and you may be wondering, “does hemophilia get worse with age?”
Joint pain may feel different than it did years ago. Routine screenings become more common. Conditions such as high blood pressure, diabetes, or heart disease may enter the picture. You may need guidance about surgery or other medical procedures.
Learning more about aging with hemophilia can help you prepare for a conversation with your hematology team and help you make more informed choices to advocate for your health.
Learning how to age with hemophilia
Advances in treatment have changed what it means to live with hemophilia. Life expectancy with hemophilia has increased, and many people with this bleeding disorder enjoy a quality of life that was far less common in previous generations.
Aging with hemophilia means managing both the effects of a bleeding disorder and the same age-related health conditions that affect everyone, such as cardiovascular disease, high blood pressure, diabetes, and reduced bone density.
For some people, the effects of past bleeds can also become more noticeable over time, including joint damage and mobility challenges. Access to veins for treatment (venous access) may also become more challenging with age.
This means it’s especially important to be proactive about your care, including maintaining regular communication with your hematology care team. New symptoms, medication changes, and upcoming procedures should be discussed early so age-related concerns and hemophilia care can be managed together.
How hemophilia affects joint health over time
Many adults with hemophilia assume joint pain is simply something they need to live with after years of managing bleeds. While joint problems can happen, changes in pain, mobility, swelling, or balance are still worth discussing with your care team. Not every new symptom should automatically be attributed to hemophilia or aging.
That said, repeated bleeding into a joint can irritate the joint lining and damage cartilage and bone. In people with severe hemophilia, repeated bleeds can lead to progressive joint damage and reduced mobility over time.
Even younger adults may experience hemophilic arthropathy, a long-term form of joint disease that commonly affects the ankles, knees, and elbows. Pain, stiffness, swelling, reduced range of motion, and changes in the way you walk can make daily tasks harder.
Hemophilic arthropathy differs from osteoarthritis, which develops through age-related wear and tear. A new or changing symptom should be assessed rather than assumed to be “just hemophilia” or “just getting older.”
Your team may discuss physical therapy, activity adjustments, pain management, mobility support, or an assessment by a bone and joint specialist. These options are individualized. You should speak to a healthcare professional before you start, stop, or change pain medicine because some medicines can affect bleeding or interact with other treatments.
Age-related conditions and hemophilia
As you get older, hemophilia becomes one part of a broader health picture. Adults with hemophilia can develop many of the same conditions that affect people without a bleeding disorder, including high blood pressure, heart disease, and cancer.
49%
have hypertension
49% of adults with hemophilia have hypertension, compared with about 32% of the general population.
Heart health
People with hemophilia can still develop cardiovascular disease, high blood pressure, and other heart-related conditions. In fact, as people with hemophilia live longer, heart health becomes an increasingly important part of overall care.
Routine primary care and screening for blood pressure, cholesterol, and other cardiovascular risk factors remain important. High blood pressure deserves particular attention because it is common with aging and may add to the risk of serious bleeding in people with bleeding disorders.
Some cardiovascular conditions are treated with antiplatelet or anticoagulant medicines, often called blood thinners. While this may sound incompatible with hemophilia, these decisions are carefully assessed and personalized by hematology and cardiovascular specialists. You should not start, stop, or adjust these medicines without speaking to a healthcare professional.
Cancer
You may also have questions about hemophilia and cancer. Cancer screening may become part of routine care as you get older, based on your age, health history, and individual risk. This could involve tests or procedures that may cause bleeding, such as colonoscopy with possible biopsy or polyp removal, all of which should be planned carefully with your hematology team and the clinician performing the procedure.
Liver health
Liver health may also be part of routine follow-up appointments, particularly for people with a history of hepatitis infection or other liver risk factors. The liver makes many clotting proteins, and liver disease can add another layer to bleeding management.
Immune system
The immune system gradually changes with age, so it’s important to keep up with the recommended vaccinations and health checks as you get older. You can read more about How your immune system changes with age.
Bone health, falls, and staying active
Joint damage receives a good deal of attention, but bone health is also an area where hemophilia adds a layer of complexity. Research has found that low bone mineral density is more common in people with hemophilia.
Staying physically active with an exercise plan suited to your joint health and bleeding history can support muscle strength, balance, and bone health. A physical therapist or hemophilia specialist can help identify activities and adjustments that fit your needs and goals.
Simple fall-prevention measures can also help, including:
- Keeping walkways clear
- Improving home lighting
- Wearing stable footwear
- Communicating any concerns about your balance or vision
Your care team can advise whether bone-density screening, physical therapy, or a falls assessment is appropriate.
Nutrition also remains important as you age, and eating a balanced diet may help support bone, heart, and overall health. There is no single hemophilia diet that is right for everyone, but nutrition can play an important role in supporting bone health, heart health, healthy weight maintenance, and overall wellness.
63%
have decreased bone mineral density
63% of adults with hemophilia have decreased bone mineral density, with more severe hemophilia associated with lower bone mineral density scores.
Planning for surgeries or procedures with hemophilia
Common later-life procedures such as joint replacement, dental work, cataract surgery, and colonoscopy are not off limits for people with hemophilia, but preparation is key. The hematology team and the procedural or surgical team should be jointly involved in the planning of the procedure. The plan depends on the procedure, hemophilia type and severity, inhibitor status, current treatment, and personal medical history.
Contact your hemophilia treatment center (HTC) as soon as a procedure is suggested, rather than waiting until the date is set. The teams may need time to agree on bleeding protection, laboratory monitoring, anesthesia considerations, pain management, and follow-up. Do not rely on general guidance found online, because the right plan should be personalized.
Questions to ask when a procedure is proposed:
- When should my hematology team speak with the procedural team?
- Does the facility have experience caring for people with bleeding disorders?
- What information should I carry on the day of the procedure?
- Who should I call about bleeding, pain, or other concerns after I go home?
Your hemophilia care team as you age
A hemophilia treatment center, or HTC, can act as the hub for comprehensive care. HTCs bring together hematology expertise with nursing, physical therapy, social work, and connections to other specialists.
Keep your HTC team informed about:
- New diagnoses
- Prescriptions
- Over-the-counter medicines
- Supplements
- Urgent-care visits
- Planned medical procedures
Tell other clinicians, dentists, and pharmacists that you have hemophilia and share your hematology contact information. A medical alert card or digital health information may help in an emergency.
Medication reviews become especially important with age as more clinicians are involved in your care. Bring an updated medication list to appointments and ask whether any medicines or supplements could affect bleeding risk or interact with treatment.
If you are caring for an older adult with hemophilia, you are an important part of their care team. Ask how the person would like you to help, whether that means taking notes, keeping a medicine list up to date, or joining appointments, while allowing them to lead discussions about their care if they want to.
Medicare and coverage planning
As healthcare needs become more complex, insurance and coverage questions may become a larger part of overall care planning.
If you are approaching Medicare eligibility, ask an HTC social worker or benefits specialist about Medicare timing, plan options, and continuity of care. Medicare and Medicaid rules, coverage, networks, and out-of-pocket costs can change and vary by eligibility and location, so individualized benefits advice is important.
Make your experience part of the plan
Growing older with hemophilia may be new territory, but you bring years of knowledge about your body and your care. Pairing that experience with coordinated preventive care can help you address new concerns about how to care for your joint, heart, and bone health, and prepare for procedures as someone with hemophilia.
Hemophilia treatment is evolving, and understanding your options and the latest guidance can help you manage your condition going forward. Use this information to prepare for a conversation with your doctor and care team about managing hemophilia as you age.
Download the Doctor Discussion Guide to organize your questions and identify what you would like to discuss.
Sign up to get hemophilia guidance.
form_builder_uat_2334
form_builder__production__2334__wd
Thanks for
your interest.
You’ve been subscribed.
Frequently asked questions
What is the life expectancy of someone with hemophilia today?
The average lifespan of people with hemophilia has improved greatly over recent decades, especially with access to comprehensive care, but individual outcomes depend on treatment history, other health conditions, and access to care.
What is the current treatment landscape for hemophilia?
The hemophilia treatment landscape includes established and newer approaches, but the right option depends on hemophilia type, severity, inhibitor status, bleeding history, other health conditions, and personal priorities. Do not start, stop, or switch treatment based on general information; discuss options with your hematology team.
How can hemophilia joint swelling be controlled?
If you think you may have hemophilia joint swelling, speak to your care team or a healthcare professional immediately. Treatment for joint swelling may include medication to control the bleed.
Is joint replacement surgery possible for people with hemophilia?
Joint replacement may be possible for some people with hemophilia when hematology, orthopedic, anesthesia, rehabilitation, and other teams plan care together. The risks and plan depend on the individual.
Does mild hemophilia matter more as you get older?
People with mild hemophilia may experience an increased risk of bleeding as they get older and have more age-related procedures or health conditions.
Can I get diagnosed with hemophilia in adulthood?
Yes, hemophilia can be diagnosed in adulthood, particularly when symptoms are mild and were not recognized earlier.
How do I navigate Medicare or Medicaid with hemophilia?
Generally, United States residents become eligible for Medicare benefits when they turn 65. Some people with bleeding disorders may qualify for Medicare sooner than that, depending on their condition.
Medicaid coverage with hemophilia depends on eligibility, the plan, the provider network, and current program rules. An HTC social worker, benefits specialist, or official program representative can help you review coverage and continuity-of-care questions.
More relevant articles
Keep reading
- /hemophilia/education/hemophilia-types-von-willebrand-disease
- /health/education/types-of-blood-disorders
- /hemophilia/education/hemophilia-in-women-and-girls
- /vaccines/education/aging-and-immune-system
References
Booth JS, Toapanta FR. B and T cell immunity in tissues and across the ages. Vaccines. 2021;9(1):24. doi:10.3390/vaccines9010024
Centers for Disease Control and Prevention. Hemophilia Treatment Centers (HTCs). Reviewed May 15, 2024. Accessed September 28, 2026. https://www.cdc.gov/hemophilia/treatment/index.html
Franchini M, Focosi D, Mannucci PM. How we manage cardiovascular disease in patients with hemophilia. Haematologica. 2023;108(7):1748-1757. Published 2023 Jul 1. doi:10.3324/haematol.2022.282407
Gualtierotti R, Solimeno LP, Peyvandi F. Hemophilic arthropathy: current knowledge and future perspectives. J Thromb Haemost. 2021;19(9):2112-2121. doi:10.1111/jth.15444
Konkle BA, Huston H, Nakaya Fletcher S. Hemophilia A. In: Adam MP, Feldman J, Mirzaa GM, et al., eds. GeneReviews®. University of Washington, Seattle; 2000-. Updated June 15, 2023. Accessed September 28, 2026. https://www.ncbi.nlm.nih.gov/books/NBK1404/
Lewandowska M, Lim MY. The aging hemophilia patient. Hematology Am Soc Hematol Educ Program. 2025;2025(1):674-681. doi//doi.org/10.1182/hematology.2025000773. Accessed September 28, 2026. https://ashpublications.org/hematology/article/2025/1/674/556916/The-aging-hemophilia-patient
Mejia-Carvajal C, Czapek EE, Valentino LA. Life expectancy in hemophilia outcome. J Thromb Haemost. 2006;4(3):507-509. Available at: https://www.jthjournal.org/article/S1538-7836(22)12167-7/fulltext. Accessed September 28, 2026.
National Bleeding Disorders Foundation. MASAC Document 223: Recommendations on Liver Biopsy in Individuals with Hemophilia. Published October 06, 2013. Accessed September 28, 2026. https://www.bleeding.org/healthcare-professionals/guidelines-on-care/masac-documents/masac-document-223-recommendations-on-liver-biopsy-in-individuals-with-hemophilia
Ransmann P, Hmida J, Brühl M, et al. The influence of severity of hemophilia on bone mineral density and fracture risk. Research and Practice in Thrombosis and Haemostasis. 2024;8(8):102624. doi:10.1016/j.rpth.2024.102624
Srivastava A, Santagostino E, Dougall A, et al. WFH guidelines for the management of hemophilia, 3rd edition. Haemophilia. 2020;26(suppl 6):1-158. doi:10.1111/hae.14046
Tuinenburg A, Mauser‐Bunschoten EP, Verhaar MC, Biesma DH, Schutgens REG. Cardiovascular disease in patients with hemophilia. Journal of Thrombosis and Haemostasis. 2009;7(2):247-254. doi:10.1111/j.1538-7836.2008.03201.x
U.S. Department of Agriculture, U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. Published December 2020. Accessed September 28, 2026. https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf
Von Drygalski A, Kolaitis NA, Bettencourt R, et al. Prevalence and risk factors for hypertension in hemophilia. Hypertension. 2013;62(1):209-215. doi:10.1161/HYPERTENSIONAHA.113.01174