I am a symptomatic carrier with easy bruising, a hisory of severe menorrhgia & chronic anemia, and a hemarthosis after a minor knee injury. I avoid aspirin and NSAIDs--do I need to?

Good question. The term 'symptomatic carrier' is broad, and can characterize hemophilia A and B carriers with no factor deficiency (FVIII or FIX >50%) to patients with FVIII/FIX from <1%-49%.  If it is the latter, then there is no evidence that occasional use of aspirin or NSAIDs for pain is wrong. I would consider avoiding it prior to surgery or if you are a carrier with levels in the "hemophilia range." However, the best way to be able to treat your hemophilia is to have an accurate understanding of your own factor levels. Some carriers have factor levels low enough to be diagnosed with mild hemophilia; getting your own factor levels tested could help, especially prior to surgery.

-Dr. Expert