Hypnosis and bleeding disorders: a narrative review-with a focus on hemophilia.

Abstract

Background and objective: Hypnosis has been explored for its therapeutic effects in bleeding disorders since the 1960s, yet this relationship remains inadequately characterized in contemporary medical literature. This study aimed to provide a narrative review examining the relationship between hypnosis and bleeding disorders, with emphasis on hemophilia, and identify evidence gaps.

Methods: A literature search was conducted using PubMed (1946-October 2025) with keywords "Hypno*" AND "Bleed*" without restrictions on article origin, language, or study design.

Key content and findings: Of 527 articles identified, 37 were retained, predominantly case reports and small trials. Twenty-five articles (68%) focused on hemophilia. Four randomized controlled trials were identified (total n=90). Publications concentrated in 1960-1980 (40.5%), with declining frequency thereafter. Evidence on bleeding reduction is mixed: historical studies suggested reduced bleeding frequency and factor use, while recent trials showed non-significant trends. Contemporary research focuses on quality of life, with hypnosis demonstrating significant improvements in pain interference with daily activities and health-related quality of life, despite not reducing absolute pain intensity. Effects persisted at three-month follow-up. Hypnosis showed good feasibility and safety, with 90-100% retention rates and no adverse events. Additional evidence supports hypnotic interventions in surgical bleeding, menstrual disorders, gastrointestinal hemorrhage, epistaxis, and hematuria.

Conclusions: Hypnosis demonstrates promise as an adjunctive intervention in bleeding disorders, particularly for improving quality of life in people with hemophilia. Contemporary protocols focus on relaxation and anxiety reduction rather than direct bleeding control, reflecting understanding of stress-mediated effects on hemostasis. Future adequately powered trials should elucidate mechanisms and identify patient populations most likely to benefit. Given consistent evidence for improved health-related quality of life and safety, hypnosis warrants consideration as a component of comprehensive care for bleeding disorders.