Your Periods May Get Lighter
About 60 percent of women older than age 40 begin to experience lighter and more manageable periods, explains Dr. Einhorn. Having very light periods or even skipping a period is normal and no reason for concern. Just enjoy having a cycle thats a little easier to handle. Even if your period is irregular or barely there, you can still get pregnant. You wont officially reach menopause until its been a year since your last period, which occurs on average around age 50.
What Do Large Blood Clots During A Period Mean
For some women, the discomfort of menstruation can mean a day or two away from work each month. Symptoms like heavy flow, abdominal cramps, and back pain are made even worse by the presence of blood clots during period. Theyre frightening to see and difficult to understand. But the professionals at North Texas Fibroids in Flower Mound, Cedar Hill, and Dallas, TX, can ease your fears, answer questions, and even provide relief.
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What Causes Heavy Menstrual Bleeding With Clots
In some cases, the reason for heavy menstrual bleeding with clots is unknown, but a number of conditions may cause the issue. Typical causes consist of:
- Hormone imbalance. In a normal menstrual cycle, a balance between the hormones estrogen and progesterone manages the buildup of the lining of the uterus , which is shed during menstruation. If a hormone imbalance takes place, the endometrium establishes in excess and ultimately sheds by method of heavy menstrual bleeding.
- A variety of conditions can cause hormone imbalances, including polycystic ovary syndrome , obesity, insulin resistance and thyroid issues.
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When Is A Heavy Period Too Heavy
It is difficult to measure blood loss accurately. Some medical definitions of blood loss during a period are:
- A normal period is a blood loss between 30 and 40 ml per month. Bleeding can last up to eight days but bleeding for five days is average.
- A heavy period is a blood loss of 80 ml or more. This is about half a teacupful or more. However, it is difficult to measure the amount of blood that you lose during a period.
- For practical purposes, a period is probably heavy if it causes one or more of the following:
- Flooding through to clothes or bedding.
- You need frequent changes of sanitary towels or tampons.
- You need double sanitary protection .
- Soaking of bedclothes.
- You pass large blood clots.
- Restriction to your normal lifestyle because of heavy bleeding.
- Menorrhagia means heavy periods that recur each month. Also, that the blood loss interferes with your quality of life. For example, if it stops you doing normal activities such as going out, working or shopping. Menorrhagia can occur alone or in combination with other symptoms.
Expert Management For Painful Periods And Heavy Bleeding
For most women, menstrual cycles occur about every 28 days, and periods last four to seven days. Abnormal menstruation includes problems such as heavy bleeding, known as menorrhagia, irregular menstrual bleeding, and pain during periods, known as dysmenorrhea.
UT Southwestern gynecologic surgeons, specialists, and their teams are nationally recognized for their expertise in womens health care. We participate in research to improve diagnosis, management, and treatment for heavy, irregular, painful periods. Our specialists are also faculty members, dedicated to educating future womens health doctors and other care providers.
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When To See A Healthcare Provider
Verywell / Emily Roberts
See your healthcare provider if you experience any of the following:
- Blood clots are larger than a quarter
- An excessive amount of blood clots
- Menstrual bleeding that is heavy and requires you to change your tampon or pad every couple of hours
- Bleeding lasts longer than seven days
- Extreme abdominal pain with nausea or vomiting
Pay Attention To Your Bodys Signals
Your period can be an indicator of your reproductive health. Paying attention to this each month will help you identify concerns, including blood clots. While some are normal, their continued presence can be a sign of uterine fibroids. The good news is that our office is well-equipped to treat fibroids with UFE, a minimally invasive therapy with fantastic results.to schedule your appointment.
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During The First Trimester
When a miscarriage occurs in the first five weeks after fertilization, its called a chemical pregnancy. Its so early that you might not have known you were pregnant.
Although your period may seem heavier than usual, there might not be any other noticeable sign of miscarriage.
Miscarriages in the first trimester often have to do with chromosome abnormalities that interfere with normal development. Missing or extra chromosomes are linked to 50 percent of all miscarriages.
Sometimes, a fertilized egg simply doesnt develop into an embryo .
It may help to know that having sex, exercising, morning sickness, and previous use of oral contraceptives dont cause miscarriage. Even an accidental fall doesnt necessarily cause it.
According to the American College of Obstetricians and Gynecologists , smoking and alcohol consumption in the first trimester may result in a slightly higher risk of miscarriage. But the research on this is mixed.
Its also worth noting that drinking less than 200 milligrams of caffeine per day doesnt appear to increase the risk of miscarriage.
Some things that may increase the risk of early miscarriage are:
- fibroids or other abnormalities of the uterus
- use of cocaine or similar drugs
You Might Start Breaking Out Before Your Period
Once you hit 40, “it’s like going through puberty again,” said Dr. Gupta, who warns you might start breaking out again, just like in high school. You also begin to get hot flashes and night sweats during perimenopause, but these symptoms tend to come and go as hormones fluctuate, said Dr. Dunsmoor-Su.
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Your Periods Can Come Closer Together
Because there’s no “normal” when it comes to your menstrual cycle, some individuals might experience more periods during perimenopause, according to the Office on Women’s Health. In some cases, “estrogen and progesterone surges during the menstrual cycle become shorter and higher,” said Dr. Gupta. “That means your periods could come closer together.”
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.
Controlling heavy menstrual bleeding is the best way to control menstrual clots.
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Diagnosis Of Underlying Conditions
Blood clots in and of themselves arent a medical condition, but rather a possible symptom of another underlying condition. Your healthcare provider may start trying to diagnose the cause of your blood clots by asking you some questions, such as:
- How long does your period last?
- How heavy is your usual flow?
- Have you noticed changes in your flow over time?
- Have you been pregnant before?
- Have you ever had pelvic surgery?
- Do you use birth control and, if so, what kind?
- What medications are you on?
Next, your healthcare provider will do a pelvic exam. They may also want to do some tests to figure out what might be causing your blood clots. These tests may include:
Blood Clots Healthcare Provider Discussion Guide
Get our printable guide for your next healthcare providers appointment to help you ask the right questions.
You’re Less Fertile But You Can Still Get Pregnant
Your chances of getting pregnant decrease as you move through your 40s. But you can get pregnant in this decade, said Dr. Dunsmoor-Su. “There is an ovulation 14 days before each period as long as you have your period,” Dr. Dunsmoor-Su explained. “However, eggs at this time of life tend to be of poor quality with a lot of genetic ‘mistakes,’ and miscarriage rates are very high.” You should still use birth control if you don’t want to get pregnant in your forties.
Changes in your cycle over time are normal, but they could signal abnormalities, and sometimes it’s hard to tell the difference. Don’t immediately assume the worst if you experience one month of period weirdness. But “if you have significant sudden changes in your cycle, you should see an ob-gyn for evaluation for possible structural causes or pre-cancer syndromes,” suggested Dr. Dunsmoor-Su.
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Is My Period Bleeding Heavy
Heavy period bleeding is common. This doesnât mean you should just live with it, because it can have negative impacts on your health. That is why healthcare providers call it âabnormal uterine bleedingâ . Heavy bleeding includes any of the following :
Soaking one or more tampons or pads in an hour for two or more hours
Clots larger than a quarter
Vaginal bleeding lasting longer than 7 days
Needing to change pad/tampon/cup during the night
Needing to wear more than one pad at a time
Keeping A Menstrual Diary
It may be worth keeping a diary for a few periods . Your doctor may give you a period blood loss chart which you can fill in. Basically, you record the number of sanitary towels or tampons that you need each day and the number of days of bleeding.
A diary is useful for both patient and doctor to see:
- How bad symptoms are and whether treatment is needed.
- If treatment is started, whether it is helping. Some treatments take a few menstrual cycles to work fully. If you keep a diary it helps you to remember exactly how things are going.
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You Might Start Skipping It Here And There
Don’t freak out if your period goes entirely MIA one month. “A skipped period is the first sign of deteriorating egg quality,” said Dr. Dunsmoor-Su. “Some months, the eggs just don’t reach a point where they release, and so a period gets missed.” Remember: You’re not in menopause until you go an entire year without a period, so skipping a month doesn’t necessarily mean you can toss all your pads and tampons.
Nearing 40 Expect Changes To Your Period
Chances are youve been managing, trackingand perhaps lamentingyour period for decades. And you may know your menstrual cycle well. But dont get too comfortable change is likely just around the corner.
Some women believe their period changes after pregnancy. But its our age that affects our menstrual cycle, explains , OB/GYN at Main Line Health. Around age 40, expect to see some changes in your period.
Heres whats possible:
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There Will Be Blood: Women On The Shocking Truth About Periods And Perimenopause
The menopause brings an end to menstruation but in the lead-up, many women experience periods that can disrupt their lives and careers
If Emma Pickett needs to make a long journey, she checks her calendar very carefully. She will often take an emergency change of clothes when she goes out, and if giving a lecture for work, has to ensure it is no longer than half an hour. Yet she rarely hears anyone talk about the reason so many older women secretly go to all this trouble why theyve started to stick to black trousers, give up the sports they loved, or plan days out especially with children meticulously.
If you have a bunch of 12-year-olds in the car, you cant say: Sorry chaps, Im just bleeding heavily today, says Pickett, a 48-year-old breastfeeding counsellor and author of The Breast Book, who also happens to be among the one in five British women who suffer from heavy periods in the run-up to menopause . You can talk about hot flushes, make a joke about it. But because menstrual blood is gross in our society, theres no conversation about it. There must be women round the world just pretending they need to dash off for some other reason.
No one says erectile dysfunction is just part of mens lives. We say this is a typical thing and theres treatment
Ive come across women who are having extended sick leave because they didnt feel able to manage their bleeding
What Tests Might Be Needed For Heavy Periods
Your doctor might do or advise one or more of the following tests:
- An examination to see whether the bleeding is coming from your cervix, not your uterus. This is done in a similar way as a cervical smear or HPV screening test.
- Blood tests to look for anaemia, iron levels, thyroid disease or a bleeding disorder.
- An ultrasound of your uterus and ovaries to detect abnormalities in your uterus, such as polyps or fibroids.
- A cervical smear in which a sample of cells is collected from your cervix and then looked at to see if you have an infection, inflammation or changes in the cells that might be or cause cancer.
- A sample of the lining of the uterus to see whether there are any precancerous or cancerous changes.
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Cancer Of The Endometrium
Cancer that affects the endometrium of the uterus can cause bleeding in women especially after 40 years. However, younger women may have prolonged heavy period, abdominal pain and vaginal pain during intercourse.
If your doctor suspects cancer as the cause of your long heavy periods, removal of the uterus or hysterectomy will be performed. Removal of the uterus with radio or chemotherapy can achieve cure if done early.
Dr Armstrongs Top Tips
If youre experiencing abnormally heavy bleeding or excessively long periods and this is negatively impacting your life:
- Keep a diary of your menstrual cycle and heavy bleeding during menopause and note any other possible perimenopausal symptoms
- Make an appointment to see your doctor
- Consider an iron supplement if you have been bleeding heavily long-term
- Be prepared! Always have extra sanitaryware with you. Being prepared at all times will make you feel in control of your situation and more able to cope
- Check out Stella for a personalised plan to manage menopause symptoms
- Visit NICE for current evidence-based guidance and Patient
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For Chronic Abnormal Uterine Bleeding
- If the woman is not wanting to become pregnant in the near future and there is no distortion of the endometrium on ultrasound then Mirena is the recommended first line treatment.
- If Mirena is not suitable due to contraindication or patient preference:
- first choice is continuing on the oral contraceptive pill as this is protective against endometrial carcinoma
- second choice: progestogens . Starting doses: medroxyprogesterone acetate 10 mg od or norethisterone 5 mg bd. Note this does NOT provide contraception.
Trial for at least 3 full months and preferably 46 months.
- Antifibrinolytics: Tranexamic acid 1 g tds for 35 days, and/or
- NSAIDs: Ibuprofen 400mg tds for 34 days.
How Is Heavy Bleeding Diagnosed
After a thorough history and clinical examination including a cervical screening test and swabs your doctor might order blood tests and/or a pelvic ultrasound to eliminate some of the possible causes listed previously. The gold standard is to perform a hysteroscopy and curette in all women over 35 years of age to rule out endometrial hyperplasia or cancer. This is where the lining of the womb is viewed with a telescope the hysteroscope and is then lightly scraped away and a biopsy taken for examination.
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Is It Normal For Period Blood To Come Out In Clumps
During my period most of my blood comes out in quarter-sized clumps. My periods are normally heavy, but do these clumps mean that something is wrong?Jessica*
Its perfectly normal to notice some clumps from time to time during your period. These are blood clots that may contain tissue. As the uterus sheds its lining, this tissue leaves the body as a natural part of the menstrual cycle. So clots of tissue are usually nothing to be concerned about. But if you notice large or frequent clots, talk to your health care provider to make sure your period is normal.
You also mention that your periods are heavy. If your period soaks through more than one pad or tampon every 12 hours, talk to your doctor or nurse practitioner. Its also a good idea for a girl to get checked out if her periods last for longer than a week or if she is having a lot of pain with her periods.
*Names have been changed to protect user privacy.