OBJECTIVES: Von Willebrand disease (VWD) is a bleeding disorder affecting about 1% of the general population.  This study explored relationships between bleeding disorders, menorrhagia, iron deficiency and HRQL.  It was hypothesized that females with bleeding disorders would have low HRQL associated with menorrhagia and iron deficiency. METHODS: All males and females with VWD, and females with other bleeding disorders, in the Canadian national registry, who were older than 12 years of age and literate in English or French, were eligible for survey in this cross-sectional population-based study. Measures included the Health Utilities Index Mark 3 utility scores of HRQL; abridged Clinical History Assessment Tool for menorrhagia; socio-demographic questions; and blood for serum ferritin. Iron deficiency was defined as serum ferritin ≤ 20 mcg/L. Statistical analyses included testing differences among groups of means using analysis of variance, and of proportions using chi-square.  Statistical significance was set at the 5% level. RESULTS: 413 subjects participated.  There was a significant difference (p=0.026) among mean HRQL scores for females with VWD (0.701), females with other bleeding disorders (0.783) and males with VWD (0.767).  Among menstruating females (n=185), there was: no significant difference (p=0.108) in mean HRQL scores between females with VWD and females with other bleeding disorders; a high (p<0.001) prevalence of menorrhagia (44%) compared to controls (11%); a significant difference (p<0.001) in mean HRQL scores for those with / without (0.643 / 0.816) menorrhagia; and no association (p=0.740) between menorrhagia and iron deficiency. CONCLUSIONS: Females with VWD have lower HRQL than females with other bleeding disorders and males with VWD.  Menorrhagia is prevalent and associated with lower HRQL, but not iron deficiency, among menstruating females with bleeding disorders. Future research should investigate better management of menorrhagia for improving HRQL.