Could your bleeding or other symptoms be due to hereditary factor X deficiency?

Hereditary factor X (10) deficiency is a rare bleeding disorder that can be serious. It affects about 1 in 1 million people. If you have factor X deficiency—or think you might—this page is for you.

What Is Factor X Deficiency?

Factor X deficiency (spoken as “factor 10”) is a rare bleeding disorder caused by having too little of a clotting factor called factor X in the blood. Or sometimes, people have enough factor X but it does not work the way it should. Hereditary factor X deficiency is factor X deficiency that runs in families, meaning it can be passed down from parents to a child. However, some people with hereditary factor X deficiency do not know of another family member with a bleeding disorder.

Factor X works by helping with blood clotting to stop bleeding or prevent unusual bleeding. Bleeding can happen inside the body (for example, in a joint) or on the outside of the body (as with a skin cut). People with factor X deficiency may bleed more than normal and have a hard time getting bleeding to stop.

Symptoms of factor X deficiency sometimes can be confusing or hard to understand. For example, symptoms may include joint swelling and pain that are caused by bleeding inside a joint.

Graphic depicting continuous bleeding when there's not enough clotting factor

Symptoms of factor X deficiency may include—

Woman icon

Symptoms in women:

  • Heavier or longer bleeding during periods than most other women (heavy menstrual bleeding)
  • Bleeding complications during pregnancy or childbirth
Newborn baby icon

Symptoms in newborns: Umbilical cord (belly button) or circumcision bleeding that does not stop normally, abnormal bruising or bleeding, or brain or stomach bleeding

Symptoms in anyone of any age:

  • Bruising on skin illustration icon
    Easy bruising
  • Nose bleed illustration icon
  • Bleeding in joints illustration icon
    Joint swelling/pain
  • Bleeding gums illustration icon
    Gum bleeding
  • Excessive bleeding from injury illustration icon
    Excessive bleeding after injury
  • Internal bleeding in stomach illustration icon
    GI bleeding (stomach or intestines)
  • Internal bleeding in brain illustration icon
    Bleeding in the brain

Did you know?

  • About 1 in 5 people with factor X deficiency have had a brain bleed
  • People with factor X deficiency may have a high risk of severe bleeds
Ask your doctor about testing for bleeding disorders if you have any of these symptoms.

How Do I Know if I Have Factor X Deficiency?

Talk with your doctor if you think you may have factor X deficiency. Your doctor may ask about your symptoms, medical history, and family history of bleeding problems, and offer lab testing to diagnose your condition.

Symptom checklist icon

Help your doctor help you.

  1. Download the Symptom Screener.
  2. Save and print, or email the questions and answers to show your doctor.
  3. Ask your doctor about getting tested for bleeding disorders.

Hemophilia treatment centers

Many patients with factor X deficiency seek diagnosis and treatment at a Hemophilia Treatment Center (HTC). More than 140 HTCs are found across the US. They provide high-quality care for people with all types of bleeding disorders. Talk with your doctor about HTCs.

A patient's journey to diagnosis

Diagram showing the steps to Factor X deficiency diagnosis including: 1. history of symptoms, 2. ruling out other bleeding disorders, 3. testing and 4. diagnosis.

Certain lab tests may give your doctor clues to test you further for factor X deficiency. For example, if the two tests below are both longer than normal, ask your doctor about being tested for factor X deficiency:

Icon for longer than normal Prothrombin Time (PT)
Prothrombin Time (PT) is longer than normal
Plus sign
Icon for longer than normal Activated Partial Thromboplastin Time (aPTT)
Activated Partial Thromboplastin Time (aPTT) is longer than normal
Equals sign
Icon for blood test
Ask your doctor about a factor X deficiency test

Hereditary Factor X Deficiency Severity

  • Bleeding risk for hereditary factor X deficiency is rated as severe, moderate, or mild based on the level of factor X in the blood and bleeding symptoms1
  • Your doctor can do a blood test to find out the level of factor X in your blood
Illustration depicting blood with severe hereditary factor X deficiency
Less than 10 units (IU/dL) of factor X
Illustration depicting blood with moderate hereditary factor X deficiency
10 to 40 units (IU/dL) of factor X
Illustration depicting blood with mild hereditary factor X deficiency
>40–65 units (IU/dL) of factor X
People with lower factor X levels usually have more severe symptoms. But bleeding symptoms can be seen at any level—mild, moderate, or severe.
Talk with your doctor to learn more about the level of factor X in your blood and your disease severity

How Is Hereditary Factor X Deficiency Treated?

Hereditary factor X deficiency is treated by replacing the factor X that is missing in the body. How often treatment is needed depends on how often you have symptoms and how severe they are.

Calendar and clock icon

Routine (prophylaxis):

  • Routine treatment means you take a medicine regularly as directed by your doctor to help prevent bleeding before it happens.
    Factor X kept at near normal blood levels between doses
    Illustration of Factor X in the blood to control bleeding for preventative treatment
  • This may be the right choice if your symptoms are regular, affect your daily activities, are painful, or if you have severe (bad) bleeds.
Blood droplet and hand icon

As needed (on-demand):

  • You may decide to treat each time you bleed. Treatment as needed can help to stop a bleed after it starts.
    Factor X is given to raise levels to help stop bleeding
    Illustration of extra Factor X in the blood to stop non severe bleeding for on-demand treatment
  • This may be the right choice if you bleed very rarely, if bleeding does not affect your daily activity, or if your bleeding is not severe.


  • Treatment may be given with surgery to help prevent bleeding.
  • This may be the right choice even if you bleed rarely or your bleeding is not severe, or your daily activity is not usually affected by it.
  • After surgery, patients can change to routine therapy, or treatment as needed.
Doctor icon
If you have hereditary factor X deficiency, replace the factor X that is missing with COAGADEX.
Ask your doctor if COAGADEX is right for you.

Reference: 1. Peyvandi F, Auerswald G, Austin SK, et al. Diagnosis, therapeutic advances, and key recommendations for the management of factor X deficiency. Blood Reviews. 2021;50:100833.

Replace exactly what's missing

Indications and Usage for COAGADEX

COAGADEX, a plasma-derived blood coagulation factor X concentrate, is indicated in adults and children with hereditary factor X deficiency for:

  • Routine prophylaxis to reduce the frequency of bleeding episodes
  • On-demand treatment and control of bleeding episodes
  • Perioperative management of bleeding in patients with mild, moderate and severe hereditary factor X deficiency

Contraindication for COAGADEX

COAGADEX is contraindicated in patients who have had life-threatening hypersensitivity reactions to COAGADEX.

Important Safety Information for COAGADEX

Allergic type hypersensitivity reactions, including anaphylaxis, are possible with COAGADEX. If symptoms occur, patients should discontinue use of the product immediately, contact their physician, and administer appropriate treatment.

The formation of neutralizing antibodies (inhibitors) to factor X is a possible complication in the management of individuals with factor X deficiency. Carefully monitor patients taking COAGADEX for the development of inhibitors by appropriate clinical observations and laboratory tests.

COAGADEX is made from human plasma and may contain infectious agents, e.g. viruses, the variant Creutzfeldt-Jakob disease (vCJD) agent and, theoretically, the Creutzfeldt-Jakob disease (CJD) agent. No cases of transmission of viral diseases, vCJD or CJD, have been associated with the use of COAGADEX.

In clinical studies, the most common adverse reactions (frequency ≥5% of subjects) with COAGADEX were infusion site erythema, infusion site pain, fatigue and back pain.

Please see complete Prescribing Information for COAGADEX.