VWF and von Willebrand disease (hereditary or acquired): Management of gynecological bleeding in VWD is based on ovulation suppression by continuous combined oral contraception, regular von Willebrand factor replacement therapy, and correction of iron deficiency anemia [4]. Despite hormonal control, women with VWD remain prone to additional gynecological bleeding events, among them hemorrhagic ovarian cysts, the second most common cause of bleeding in this population, with reported incidence between 6.8% and 52% [6-8].