How Is The Cause Of Menstrual Clots Diagnosed
To determine the underlying cause of your menstrual clots, your doctor will likely ask you about things that impact menstruation. For example, they may ask if youve had previous pelvic surgeries, use birth control, or have ever been pregnant. Theyll also examine your uterus.
Additionally, your doctor may use blood tests to look for hormonal imbalances. Imaging tests, such as an MRI or ultrasound, can be used to check for fibroids, endometriosis, or other obstructions.
Controlling heavy menstrual bleeding is the best way to control menstrual clots.
What Is Heavy Bleeding
Heavy menstrual bleeding is excessive and/or prolonged menstrual bleeding. The amount varies from woman to woman and can change at different stages in your life for example, in teenage years or approaching menopause. It is defined as blood loss greater than 80ml per cycle, or periods lasting more than seven to eight days. Heavy menstrual bleeding affects about one in five women and is a common problem in the 30-50-year-old age group.
Heavy bleeding fact sheet
What Are The Potential Causes Of Large Blood Clots During Your Period
If you are experiencing unusually large blood clots during your period, dont freak out. It doesnt always mean theres something wrong, and every woman has her own version of normal. However, there are certain conditions that large blood clots and a heavier flow during your period can point to, including:
Uterine fibroids: These noncancerous growths of the uterus may form during your reproductive years. They dont always cause symptoms, but can lead to heavy bleeding, long periods, and pelvic pain.
Endometriosis: This condition occurs when the tissue that lines the inner portion of your uterus grows outside of the uterus, often spreading to other pelvic organs. Endometriosis can cause painful periods, painful sex, heavy bleeding, and even infertility.
Adenomyosis: This condition occurs when the endometrial tissue grows into the muscular walls of the uterus, resulting in longer, heavier periods, severe cramping, or pelvic pain.
Uterine polyps: These growthscaused by an overgrowth of the endometriumattach to the inner wall of the uterus, reaching into the uterine cavity, which can cause irregular or heavy bleeding. They are typically benign, but can become cancerous.
Polycystic ovary syndrome:PCOS is a hormonal disorder characterized by high levels of androgens , sometimes leading to the development of small cysts in the ovaries. This can cause irregular periods, as well as thinning hair, acne, and weight gain.
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What Does Black Period Blood Mean
You may be alarmed to see black blood, but it isnt necessarily a reason to worry. This color is related to brown blood, which is old blood. It may resemble coffee grounds. Black blood is usually blood thats taking some extra time to leave the uterus.
Brown discharge of all shades is typically a sign of old blood. The blood has had time to oxidize, which is why its changed hues from the standard red.
Brown blood is associated with:
The beginning or end of your period
When your flow is slow, the blood may take longer to exit your body. When blood stays in the uterus longer, it may become brown in color. The blood may also be left over from your last period.
Lochia
The bleeding women experience for the first four to six weeks after delivering a baby is called lochia. It starts out relatively heavy. Then from day four onward, lochia may be pinkish or brownish in color.
Pregnancy
If you experience spotting during pregnancy, some of it may be brown if the active bleed has stopped. Its a good idea to call your doctor regardless.
Missed miscarriage
Although miscarriage may be associated with bright red bleeding, some women may experience whats called a missed miscarriage. With this type of pregnancy loss, the fetus stops developing but doesnt pass from the uterus for at least 4 weeks. You may not experience heavy bleeding or clots, but some women do develop dark brown spotting or bleeding.
Causes Of Abnormal Clotting
Physical and hormonal factors can impact your menstrual cycle and create a heavy flow. Heavy flows increase your chances of menstrual clots.
Some causes of abnormal uterine bleeding include:
- Uterine fibroids: These are noncancerous growths that develop in or around the womb and can cause heavy or painful periods.
- Endometriosis: In this condition, the tissue that lines the womb is found outside the womb, such as in the ovaries and fallopian tubes.
- Adenomyosis: This is a condition in which the endometrial tissue in your uterine lining breaks through and begins to grow in your uterine wall.
- Hormonal imbalances: Hypothyroidism, polycystic ovary syndrome , perimenopause, and menopause can cause irregular shedding of the uterine lining, resulting in clotting and heavy bleeding.
- Miscarriage: Pregnancy loss can happen very early, sometimes before you even know that youre pregnant. Clotting and bleeding are common symptoms.
- Cancer in your uterus or cervix: This is a potential but less likely source of blood clots.
- Bleeding disorders: Disorders such as platelet function disorder or von Willebrands disease may cause abnormally heavy menstruation.
- Uterine or cervical polyps: These are growths on the cervical canal or uterus.
- Precancerous changes in the uterus: This doesnt mean that you have cancer.
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What Can Happen If Bleeding Disorders Are Not Treated
Bleeding disorders can raise your risk for anemia and dangerous bleeding after surgery or childbirth. They can also affect your quality of life. Women with heavy menstrual bleeding may miss days of work or school due to side effects from blood loss, including fatigue, or the need to manage heavy bleeding.
Without treatment, bleeding disorders can also lead to:
- The need for blood transfusions7
- Arthritis and breakdown of joints
- Bleeding into other areas of the body
- Hysterectomy or other surgery. Many women who do not know they have a bleeding disorder may get a hysterectomy or other procedure to help control heavy menstrual periods.8
If you know you have a bleeding disorder, tell your doctor, nurse, midwife, and dentist to prevent dangerous complications.
Keep A Menstrual Diary
If you are having treatment of just planning on having one, a diary can be helpful. In your diary, you can record the number of pads you need each day for several menstrual periods before and after any treatment. You can also record if any flooding or interruption of your daily activities occurs during your period. Although your doctor will give you a chart, a diary can be helpful for you and your doctor.
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Not Sure What To Do Next
If you are still concerned about your heavy periods, check your symptoms with healthdirects online Symptom Checker to get advice on when to seek medical attention.
The Symptom Checker guides you to the next appropriate healthcare steps, whether its self care, talking to a health professional, going to a hospital or calling triple zero .
What Causes Menstrual Clots
Most women of childbearing age will shed their uterine lining about every 28 to 35 days. The uterine lining is also called the endometrium.
The endometrium grows and thickens throughout the month in response to estrogen, a female hormone. Its purpose is to help support a fertilized egg. If pregnancy doesnt occur, other hormonal events signal the lining to shed. This is called menstruation, also known as a menstrual period or period.
When the lining is shed, it mixes with:
- blood
- mucus
- tissue
This mixture is then expelled from the uterus through the cervix and out the vagina. The cervix is the opening of the uterus.
As the uterine lining sheds, it pools in the bottom of the uterus, waiting for the cervix to contract and expel its contents. To aid in the breakdown of this thickened blood and tissue, the body releases anticoagulants to thin the material and allow it to pass more freely. However, when the blood flow outpaces the bodys ability to produce anticoagulants, menstrual clots are released.
This blood clot formation is most common during heavy blood flow days. For many women with normal flows, heavy flow days usually occur in the beginning of a period and are short-lived. Your flow is considered normal if menstrual bleeding lasts 4 to 5 days and produces 2 to 3 tablespoons of blood or less.
Physical and hormonal factors can impact your menstrual cycle and create a heavy flow. Heavy flows increase your chances of developing menstrual clots.
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Diagnosis And Treatment For Abnormal Bleeding
Treatment of menorrhagia is possible once your doctor is aware of the condition.
Your doctor will most definitely ask of your medical history if you are an adult. This is most likely because if it were an adolescent, his or her first guess would be anovulation due to her age.
He or she may recommend you for some test procedures after he or she must have told you to keep tabs on your menstrual cycle. These tabs or notes will now help the doctor during diagnosis.
Some test which might help to diagnose menorrhagia include:
- Ultrasound or laparoscopy. These tests due to its imaging abilities help to show the image of your uterus, pelvis and ovaries using sound waves/ direct visualization and so can help detect abnormalities if spotted.
- Pap smear/test. This test works with the collection of cells from your cervix. These cells are tested to look out for inflammation or an infection around the cervix which may be cancerous and so lead to heavy bleeding when you menstruate or irregularly.
- Blood tests. Your doctor takes your blood sample and checks if there is a case of iron deficiency in your blood due to Anemia and some other problems like blood-clotting anomalies and thyroid disorder .
- Endometrial biopsy. A tissue sample of your uterine wall might be taken to a pathologist by your doctor in order to know why it keeps shedding blood.
- Further tests such as hysteroscopy, sonohysterography, etc. depending on what the previous set of tests would show.
Uterine Polyps Or Fibroids
A blockage in the uterus may stop it from contracting as it should, meaning that it cannot force the blood out as quickly as usual. The blood will leave the body more slowly so it will have more time to pool and form clumps.
The blockage can also cause a heavier flow, which results in more blood pooling.
Blockages may occur as a result of growths in the uterus. These include uterine polyps and fibroids, which are not cancerous but can cause other health issues without proper management.
Uterine polyps and fibroids consist of either endometrial or muscular tissue that grows in the uterine wall. They can cause symptoms such as:
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Symptoms Of Abnormal Uterine Bleeding
Symptoms include:
- bleeding for more than eight days
- heavy blood loss during the menstrual period for example, soaking through one or more sanitary pads or tampons every hour for several hours in a row
- needing to change your pad or tampon during the night
- have to change or restrict your daily activities due to your heavy bleeding
- bleeding or spotting between periods
- cramping and pain in the lower abdomen
- fatigue
- any vaginal bleeding after menopause.
If you think you may be experiencing heavy menstrual bleeding, you may find it useful to keep a pictorial blood loss assessment chart this can help you give your doctor an idea of how heavy your period is.
How Menstrual Clots Form
Your menstrual period starts when hormones trigger your body to shed the lining of the uterus . As the lining sheds, small blood vessels bleed.
To prevent too much blood from being lost, your body forms blood clots using a combination of plasma and platelets .
Mixed into the menstrual blood are also bits of tissue from the uterine lining. Thus, what appears to be a blood clot may actually be a clump of endometrial cells. Or, it can be a mixture of both endometrial cells and blood clots.
Dark red or blackish clots may appear during the first few days of your period when the flow is heaviest. Your period may start or end with bright red blood clots, too. This means the blood is flowing quickly and doesn’t have time to darken.
When your menstrual flow is heavier, blood clots tend to be bigger because there’s a larger amount of blood sitting in the uterus.
In order to pass larger blood clots, the cervix has to dilate a bit, causing pain that can be quite intense. This partially explains why, if you have a heavy flow, you’re more likely to have cramping.
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What Causes Golf Ball Sized Blood Clots
Having the odd clot during your period is normal, but if youre consistently having blood clots that are large , it could be a sign of uterine fibroids, non-cancerous growths that can develop in your uterus, says Dr Jessica Shepherd, an assistant professor of clinical obstetrics and gynaecology
When Do You Call Your Healthcare Provider If You Suspect Heavy Period Bleeding
You should call your provider if you’re experiencing the symptoms of heavy menstrual bleeding or anemia, or if your period bleeding has become abnormal. Tracking your periods using a calendar or app can help you identify if your periods are heavier and longer-lasting than usual. Share these notes with your provider.
You should also schedule an appointment if you notice that you’re having to double-up on menstrual products or if you’re skipping activities you enjoy because of heavy bleeding.
Can heavy menstrual bleeding be life-threatening?
Heavy periods arent usually life-threatening, but they can be if you lose too much blood. Bleeding through two or more tampons or pads each hour for two hours in a row is a sign that you should see your provider or seek emergency care immediately.
A note from Cleveland Clinic
Just because heavy periods are common doesn’t mean that you have to learn to live with the discomfort they cause. If managing your blood flow is getting in the way of your emotional and physical well-being, speak with your provider. They can provide a care path that will provide relief.
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What Is Considered Heavy Menstrual Bleeding
HMB, which used to be called menorrhagia, is prolonged or excessive heavy bleeding during periods that can be so bad it can interfere with your daily life. It can be nerve-wracking when youre just not sure why your periods are so heavy, and HMB can make you dread getting your period each month.
If you have HMB, your menstrual flow can be heavy enough to require changing your pad or tampon every hour for several hours in a row. You might also have cramps so severe it makes it difficult to do your usual daily activities. It can be hard to go to work, play sports, or even socialize because youre in pain or worrying about leaking.
Its important to remember that HMB can affect anyone, and nothing you have done is causing this heavy bleeding. Though the causes cant always be determined, its important to be aware of the condition because it could be happening as a result of an underlying issue. For example, HMB has been linked to iron-deficiency anemia, which can make you feel exhausted and short of breath, so figuring out if you have it can help you manage how youre feeling.