Fatigue and weakness

Fatigue is commonly reported in PV and may be severe enough to interfere with daily activities or work. [4]

Headaches, dizziness, and vision changes

Thicker blood and altered circulation in PV may contribute to headaches, dizziness, and sometimes blurred or transient vision changes. [5]

Itching (pruritus)

A classic PV symptom is aquagenic pruritus—itching after warm showers or baths. This symptom is thought to involve abnormal activation of itch mediators (for example, histamine-related pathways), although the exact mechanism is not fully established. [6]

Red or flushed face

Facial plethora (a ruddy, flushed appearance) is a common physical finding in PV and reflects vascular congestion related to increased red cell mass. [7]

Enlarged spleen (splenomegaly)

An enlarged spleen is common in PV and can cause fullness in the left upper abdomen or early satiety (feeling full after small meals). [8]

Blood clot risk

In PV, thrombotic patterns can differ by gender: men may have higher rates of arterial events (including myocardial infarction), while women may have more venous thrombosis. [3]

While men and women share many PV symptoms, some studies report gender-related patterns:

• Men may be more likely to experience complications from blood clots.
• Women may report microvascular symptoms (headaches, dizziness) more often.
• Overall symptom burden can be similar, but cardiovascular risk context may differ by sex and individual risk factors. [3]

Recognizing PV symptoms early is important because:

• Treatment (such as phlebotomy, low-dose aspirin, with cytoreductive therapy for selected patients) aims to reduce the risk of blood clots. [5][6]
• Managing symptoms such as itching, headaches, and fatigue can improve quality of life. [6]
• Ongoing follow-up helps clinicians detect disease progression (for example, toward myelofibrosis or acute leukemia) and adjust care when needed. [6]

1. What are the most common PV symptoms in men?

PV symptom patterns are broadly similar in men and women. Commonly reported symptoms include fatigue and headache, pruritus (often after a warm bath or shower), and facial flushing/plethora. [9][10][11]

2. Do men have a higher risk of complications than women?

Some studies suggest men have a slightly higher risk of blood clots compared with women, but risk varies by individual factors (age, prior thrombosis, cardiovascular risks). [3]

3. Can lifestyle changes help with symptoms?

Healthy habits—such as staying well hydrated, not smoking, and keeping physically active within your clinician’s guidance—can support overall cardiovascular risk reduction. These steps should complement, not replace, PV-directed medical care. [12][13]

4. Why does PV cause a red face?

Increased red cell mass and blood volume can contribute to a flushed (ruddy) appearance. [7]

5. Do men and women respond differently to treatment?

Most treatments ware used across sexes; clinicians individualize therapy based on thrombosis risk, symptoms, and treatment tolerance. [5][6]

PV — Polycythemia vera

FAQs — Frequently asked questions

1. Stuart, B. J., & Viera, A. J. (2004). Polycythemia vera. American family physician, 69(9), 2139–2144.
2. National Cancer Institute. (n.d.). SEER Hematopoietic and Lymphoid Neoplasm Database: Polycythemia vera (PV).
3. Palandri, F., Mora, B., Gangat, N., & Catani, L. (2021). Is there a gender effect in polycythemia vera?. Annals of hematology, 100(1), 11–25. https://doi.org/10.1007/s00277-020-04287-w
4. Tremblay, D., Kremyanskaya, M., Mascarenhas, J., & Hoffman, R. (2025). Diagnosis and Treatment of Polycythemia Vera: A Review. JAMA, 333(2), 153–160. https://doi.org/10.1001/jama.2024.20377
5. Fox, S., Griffin, L., & Robinson Harris, D. (2021). Polycythemia Vera: Rapid Evidence Review. American family physician, 103(11), 680–687.
6. Spivak, J. L. (2018). Polycythemia vera. Curr Treat Options Oncol, 19(2), 12.
7. Steensma, D. P., & Tefferi, A.. (2003). Polycythemia vera. In Kufe, D. W., Pollock, R. E., Weichselbaum, R. R., et al. (Eds.), Holland-Frei cancer medicine (6th ed.). BC Decker. (Reprinted/hosted in National Library of Medicine NCBI Bookshelf).
8. Spivak J. L. (2019). How I treat polycythemia vera. Blood, 134(4), 341–352. https://doi.org/10.1182/blood.2018834044
9. Grunwald, M. R., Burke, J. M., Kuter, D. J., Gerds, A. T., Stein, B., Walshauser, M. A., Parasuraman, S., Colucci, P., Paranagama, D., Savona, M. R., & Mesa, R. (2019). Symptom Burden and Blood Counts in Patients With Polycythemia Vera in the United States: An Analysis From the REVEAL Study. Clinical lymphoma, myeloma & leukemia, 19(9), 579–584.e1. https://doi.org/10.1016/j.clml.2019.06.001
10. PDQ Adult Treatment Editorial Board. (2025, May 12). Myeloproliferative neoplasms treatment (PDQ®)–Patient version. National Cancer Institute. https://www.cancer.gov/types/myeloproliferative/patient/chronic-treatment-pdq
11. Mayo Clinic Staff. (2025, May 8). Polycythemia vera: Symptoms & causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/polycythemia-vera/symptoms-causes/syc-20355850
12. McMullin, M. F. F., Mead, A. J., Ali, S., Cargo, C., Chen, F., Ewing, J., Garg, M., Godfrey, A., Knapper, S., McLornan, D. P., Nangalia, J., Sekhar, M., Wadelin, F., Harrison, C. N., & British Society for Haematology Guideline (2019). A guideline for the management of specific situations in polycythaemia vera and secondary erythrocytosis: A British Society for Haematology Guideline. British journal of haematology, 184(2), 161–175. https://doi.org/10.1111/bjh.15647
13. Blood Cancer UK. (n.d.). Looking after yourself with PV. Retrieved February 3, 2026, from https://bloodcancer.org.uk/understanding-blood-cancer/polycythaemia-vera-pv/looking-after-yourself-with-pv/