Menopause : : Very Heavy Bleeding Large Blood Clots
I have been bleeding now for past 4 weeks. The last week has seen me lose giant blood clots and I mean lots of them. In fact Ive had to stay off work these last few days as I need to be near a loo. I feel a bit shaky but I put that down to the amount of blood Ive lost. Im really worried Im going to need a hysterectomy. Has anyone else experienced this?
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What Causes Heavy Bleeding
About 50% of women with heavy menstrual bleeding have no abnormalities in their uterus. It might be related to hormonal or chemical levels in the endometrium or conditions not yet identified in the endometrium.
In the other 50% of cases, the cause might be related to:
- Pregnancy or complications of pregnancy please contact your doctor if you have bleeding during pregnancy.
- Polycystic ovary syndrome some women can have heavy menstrual bleeding if the lining of the uterus is thickened this can lead to pre-cancerous or cancerous changes.
- Endometriosis occurs when tissue similar to that found in the lining of the uterus grows outside of it.
- Endometrial polyps usually non-cancerous growths in the endometrium that look like a large ‘teardrop’ of tissue.
- Endometrial hyperplasia an overgrowth of the endometrium, which can progress to cancer.
- Endometrial cancer cancer of the uterus.
- Adenomyosis endometrium growing in small pockets inside the muscle layer of the uterus.
- Fibroids non-cancerous growths or lumps within the uterus wall.
- Intrauterine device a contraceptive device.
There is a range of other possible causes that are not as common, such as:
- hormonal disorders, such as an underactive thyroid gland
- bleeding disorders in which excessive bleeding can occur, such as Von Willebrand disease
- chronic kidney or liver disease.
When Should I See A Doctor For Heavy Periods
Heavy periods arent something that you have to put up with. If your period affects your daily life by causing you to miss work or school, cancel social activities or plan your day around bathroom breaks, its time to seek treatment.
We recommend making an appointment with one of our womens health experts if you experience any of the the symptoms described above. An expert will be able to diagnose whats causing your heavy periods and recommend effective treatments. If youre not sure whether your period is normal, just ask.
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How Do You Know If Your Bleeding Is Too Heavy
It is very difficult to determine whether your bleeding is too heavy. The best guide is to decide whether your period is having an impact on your quality of life if it is causing you to be housebound, interrupting your daily activities, or causing you stress and anxiety. The following signs might indicate you are experiencing heavy bleeding:
- bleeding or ‘flooding’ not contained within a pad/tampon
- changing a pad/tampon every hour or less
- changing a pad overnight
- clots greater than a 50-cent piece in size
- bleeding for more than seven to eight days.
What Changes In Menstruation Can You Expect
During perimenopause, your body undergoes a shift in progesterone and estrogen levels. Estrogen, specifically, rises and falls in an arbitrary manner, which in turn affects ovulation and menstrual cycles. Expect to see irregular periods, spotting, missed periods, and certain perimenopausal bleeding patterns.
Major hormonal changes are largely to blame for symptoms, such as night sweats, hot flashes, sleep disturbances, and perimenopausal bleeding.
Occasionally, youll notice heavier and longer periods , while at other times, youll notice lighter and shorter periods . Early perimenopause tends to produce shortened menstrual cycles as well as periods lasting 2 to 3 days less. In contrast, late perimenopause creates longer cycles , often associated with anovulatory menstruation .
Furthermore, missed periods might sometimes be followed by normal periods as perimenopausal bleeding patterns and cycles are highly irregular. In this phase, menstrual blood ranges in color from dark brown to bright red. You might notice brown discharge or perimenopause brown spotting throughout the month. The texture of your discharge will also vary from thin and watery to thick and clumpy.
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Stopped Or Missed Periods
There are many reasons why a woman may miss her period, or why periods might stop altogether.
Most women have a period every 28 days or so, but it’s common to have a slightly shorter or longer cycle than this .
Some women do not always have a regular menstrual cycle. Their period may be early or late, and how long it lasts and how heavy it is may vary each time.
Taking Action About Perimenopause Heavy Periods
The first thing that I tell women who come to see me is that they are not alone and they do not have to put up with this
For such a long time, heavy periods and their real impact on womens lives have been taboo subjects, with women expecting to soldier on in silence. My rule of thumb is that you should be able to do whatever you normally do in your life without your periods getting in the way. So, if your period is getting in the way of how you live and your ability to get on with your regular day-to-day activities, then its time to do something about it and see your doctor, says Dr Armstrong.
Read Amandas story on how a sub-total hysterectomy helped the exhaustion and pain of perimenopause heavy bleeding.
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Heavy Bleeding Flooding And Perimenopause
Very heavy bleeding occurs when your oestrogen levels are high relative to progesterone causing the lining of your womb to thicken more than usual. During perimenopause, your body’s main systems are working hard to adjust to the changing hormone levels that are taking place in advance of full menopause. The most difficult situation to handle is probably very heavy, extended bleeding, or flooding cycles. Some women find they are changing tampons every hour, sometimes having a very heavy bleed during inopportune times for example, at a formal dinner. This often happens at night as well as during the day. Make sure to wear liners and change tampons or pads very regularly.
If you have recurrent heavy and prolonged periods you may become anaemic as the body doesnt have time to make up for blood loss before the next period. You can end up feeling weak, exhausted, and maybe even depressed as a result of the anaemia, which then becomes associated with the menopause. Make sure to get help early on and don’t the situation develop.
Very heavy bleeding can also be caused by fibroids. If you experience prolonged heavy bleeding, seek professional advice from your GP, homoeopath or another health expert. Vaginal bleeding is not normal after the menopause so again get professional advice if this occurs.
Most Periods Until Perimenopause
An egg matures in the ovaries during a period with the help of an increased level of FSH . Itâs the follicles that produce estrogen, and the estrogen, in turn, causes the lining of the uterus to thicken, to prepare to receive a fertilized egg.
Ovulation, the release of the mature egg, creates progesterone. Most eggs arenât fertilized. What happens next is, the progesterone goes away and the endometrium is sloughed off. This is what we know as a period.
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What Causes Heavy Periods And Abnormal Bleeding
In girls, pregnancy and dysfunctional uterine bleeding are likely to cause abnormal bleeding.
In perimenopausal women, consider endometrial carcinoma. General bleeding problems such as von Willebrand’s disease may be the cause as well.
It is an abnormal thing if you have to use 2 or more pads within two 2 hours.
Heavy bleeding can also be related to the following issues:
Dysfunctional uterine bleeding . This is a heavy and/or irregular bleeding in the absence of recognizable pelvic pathology. It is associated with anovulatory menstrual cycles. Anovulation is a medical term for the situation when the ovaries do not release an oocyte during a menstrual cycle. Therefore, ovulation does not take place.
Complications in pregnancy. Heavy periods can be due to a miscarriage and it can also be as a result of an abnormal location of the placenta .
How Is Heavy Menstrual Bleeding Diagnosed
Your healthcare provider will ask a series of questions about your medical history and menstrual cycle to diagnose heavy menstrual bleeding.
Your provider may ask about:
- Your age when you got your first period.
- The number of days your period lasts.
- The number of days your period is heavy.
- Family members with a history of heavy menstrual bleeding.
- Your pregnancy history and current birth control methods.
- Current medications you’re taking, including over-the-counter ones.
Come prepared to talk about your quality of life, too. Your provider needs to know if you’ve been doubling up on menstrual products, avoiding activities or placing restrictions on your life in any way because of heavy periods.
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Why Do Period Blood Clots Form
Our bodies are engineered in a way that blood, with the help of internal chemicals, clots so that we dont bleed to death, explains Susan Wysocki, a nurse practitioner and board member of the American Sexual Health Association.
Typically, anti-coagulants released by the body during menstruation fend off period blood clots. But sometimes, especially if you have a heavy flow, not all of your uterine tissue is able to be broken down, which leads to clots forming and being released during menstruation. These clots are typically red or dark in color and appear during the heaviest days of your period.
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Why Does Menopause Cause Heavy Periods
Your natural menstrual cycle is driven by your hormones. The menopause is the time that your hormone levels fall so that you no longer experience menstrual periods. In the lead up to this cessation, your hormone levels may fluctuate erratically, causing changes to your menstrual cycle, including heavy periods.
During a normal menstrual cycle, the hormone oestrogen is produced to stimulate the thickening of the lining of the womb. When the egg is released from the ovaries, they produce the hormone progesterone.
The interplay of these two hormones means that your periods are regular and not too heavy or light. However, as you approach the menopause, sometimes an egg is not released from the ovaries, although oestrogen is still produced. This means that there is not enough progesterone to balance the effect of oestrogen, leading to heavy periods.
During the menopause, you may encounter other factors which could result in heavy periods, ranging from stress to the side effects of medication. If you suspect that there is an underlying cause to your heavy periods, then it is important to consult a doctor to tackle this.
How Is Heavy Menstrual Bleeding Treated
Treatment depends on what’s causing your bleeding, how severe your bleeding is, your health, age and medical history. Also, treatment depends on your response to certain medicines and your preferences. For instance, you may not want to have a period at all, or you may want to reduce your bleeding. In addition, your plans to get pregnant will affect your treatment options.
Talk with your provider about your health concerns and your goals for treatment.
Medications used to treat heavy menstrual bleeding
- Iron supplements improve your iron stores.
- Nonsteroidal Anti-inflammatory Drugs like Ibuprofen® or Aspirin® can ease your cramps and reduce your bleeding.
- Birth control may help make your periods more regular and lighten your blood flow.
- Hormone therapy can help balance the amount of estrogen and progesterone in your body so that your menstrual flow isn’t as heavy. HT is often recommended for heavy menstrual bleeding associated with perimenopause but comes with risks that you should discuss with your provider.
- Gonadotropin-releasing hormone agonists can temporarily stop or reduce bleeding by preventing ovulation.
- Gonadotropin-releasing hormone antagonists can manage heavy period bleeding related to fibroids.
- Desmopressin nasal spray can stop bleeding associated with von Willebrand disease by helping your blood clot.
- Antifibrinolytic medicines, like tranexamic acid, prevent clots from breaking down and causing excessive bleeding.
Procedures used to treat heavy period bleeding
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The Consistency Of Changes
If you have a heavier flow one month and it goes back to your normal flow the next month, or if you miss a cycle but all is fine after that, there is probably nothing to be concerned about.
What you shouldnt ignore is a change in your flow, frequency, or menstrual pain that becomes consistent. Those types of changes that begin to occur each month, especially a heavier flow, should not be ignored and indicate an appointment with Capital Womens Care.
What is considered normal for you is not necessarily normal for someone else. Thats why its good practice to keep track of the duration, regularity, amount of pain, and blood flow of each cycle.
How Is Abnormal Uterine Bleeding Diagnosed
A doctor will want to rule out other health problems before deciding a girl has AUB. For example, doctors might find out that a girl with heavy periods has a bleeding disorder like von Willebrand disease.
To diagnose AUB, doctors will ask questions about periods and bleeding. Expect your doctor to ask the date your last period started.
A doctor also might ask questions that don’t seem connected to bleeding like about recent weight changes or if you have ever had sex. Doctors ask these questions because conditions like polycystic ovary syndrome and some STDs can cause abnormal bleeding. If they’re not treated, they may lead to more serious health issues, like infertility .
Girls who have had sex and miss a period need to see a doctor. Missed periods could be a sign of pregnancy as well as a sign of AUB. If you have heavy bleeding or bleeding between periods, it could be an infection or other problem. For example, an ectopic pregnancy can cause bleeding, and can be life-threatening.
A doctor might do a physical exam and maybe a pelvic exam. Sometimes doctors order blood tests or ultrasound exams. Blood tests also can show if a girl has anemia.
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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
Treatment For Abnormal Uterine Bleeding
Treatment will depend on the cause, but may include:
- medication such as prostaglandin inhibitors, hormone replacement therapy or antibiotics
- dilatation and curettage involving dilation and gentle scraping of the cervix and the lining of the uterus
- change of contraception it may be necessary to explore methods of contraception other than the IUD or hormones
- surgery to remove tumours, polyps or fibroids or to treat ectopic pregnancy
- treatment of underlying disorders such as hypothyroidism or a bleeding disorder
- hysterectomy the removal of the entire uterus is a drastic last resort, generally only considered for treatment of abnormal uterine bleeding when a serious disease, such as cancer, is also present.
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What Causes Abnormal Uterine Bleeding
Most of the time, AUB happens because of changes in the body’s hormone levels.
For teen girls, one of the most common causes of hormone changes is when the body doesn’t release an egg from one of the ovaries. This is called .
The release of an egg is part of the menstrual cycle. If a girl’s body doesn’t release an egg, the hormone changes can lead to less frequent or heavy periods.
Anovulation is most likely to happen after a girl first starts getting her period. That’s because the signals from the brain to the ovaries aren’t fully developed yet. It can last for several years until a girl’s periods become regular.
Other things can lead a girl to develop AUB. Some illnesses can mess with the body’s hormones. Problems like compulsive exercise, not eating healthy foods, or too much stress can cause hormone changes. Some severe cases of AUB are caused by bleeding disorders such as von Willebrand disease.
Missed Periods Intermittent Spotting Heavy Bleeding And Flooding
Changes in periods vary widely as hormones adjust. As mentioned in other parts of this site this is a time to really tune into your body and trust your instincts. As you can see from this list it’s hard to define what perimenopause periods are like:
Periods can disappear for a year and then return.
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