Heavy periods with clots: causes, diagnosis, treatment

According to average statistics, during menstruation a woman loses from 60 to 80 ml of blood. It includes not only blood, but also mucous clots, particles of the endometrium and an unfertilized egg. But are constant heavy periods with clots normal? If not, then what could this type of menstrual flow mean and what should you do if you discover such a deviation?

What is heavy bleeding called?

When heavy bleeding during menstruation with clots can be called a pathology depends on the amount of blood released. Officially, blood loss of more than 80 ml (or 16 moistened sanitary products) during the menstrual period is considered menorrhagia.

Most women with this kind of heavy bleeding will have low hemoglobin (anemia) or signs of iron deficiency. In practice, only about a third of women are anemic. Therefore, the definition of a heavy period may be adjusted to include 9-12 regular-sized soaked sanitary products per period.

Knowing that one normal-sized soaked sanitary product contains about a teaspoon of blood (5 ml), you can calculate the approximate amount of blood you lose each day.

Another very simple way to measure bleeding is to use a menstrual cup, which has markers for 15 and 30 ml of blood loss. To measure blood loss with a menstrual cup, simply add up the estimated amounts from each bowel movement.

When a doctor's help is needed

You should seek the help of a doctor if:

• Heavy periods become regular and have many blood clots. Such phenomena can cause a malignant tumor, and prolonged delay in examination can lead to death.
• When the monthly discharge is so strong that you have to change the pad every 30 minutes. This is a very alarming symptom that requires immediate consultation with a doctor.
• If menstruation is accompanied by severe pain , which even painkillers do not relieve, and is accompanied by vomiting and fever.
• Seeing a doctor is necessary if a woman suffers from anemia. Large blood losses every month can cause irreparable damage to health.
• An immediate indication to consult a doctor is bleeding after a long delay in menstruation, especially if large clots are released. Possible ectopic pregnancy, cyst rupture or miscarriage.
• Heavy discharge during menopause, which is accompanied by pain and fever , should also be a reason to consult a doctor.

Only regular visits to the gynecologist, ultrasound examination and passing the necessary tests can prevent heavy periods and the consequences they can bring.

How to keep a menstrual diary

Keeping a menstrual diary is a useful way to estimate the amount of blood lost using the number of soaked pads, regular-sized tampons, or a menstrual measuring cup. This way, you will determine whether your periods are really heavy or within the established norm.

Only completely saturated products are counted. If the gasket was half full, count it as half.

Let's say you used three tampons and one pad a day, but they were only half full. Then you will have to multiply four by 0.5 = two to get the number of completely soaked. A "maxi" or "super" tampon or pad holds about 2 teaspoons or 10 ml of blood, so record each large soaked sanitary product as a "2".

Additionally, write a personal judgment about the amount of blood lost, where:

• “1” defines scanty discharge;
• "2" means normal flow;
• "3" is a little rich;
• “4” is very heavy with flooding.

If the number of saturated hygiene products is 16 or more, or if you write down “4”, then you should think about how to reduce heavy discharge.

Normal menstruation

All the factors mentioned above are important. And if you have black periods, only a doctor can name the reasons after an examination.

Normally, a woman's menstrual cycle lasts from 21 to 35 days. Menstruation lasts from 3 to 7 days. The discharge is red in color, the shade depends on the individual characteristics of the body, clots are acceptable. The amount of discharge normally should not exceed 50 ml.

Pain in the lower abdomen, lumbar region, and chest during menstruation is also normal.

Menstrual cycle

Normal and abnormal clots

Sometimes heavy menstruation with clots can be considered normal. If the pieces are small—no more than a quarter of a centimeter—and only random, you don't have to worry. Unlike blood clots that form in your veins, they are not dangerous in themselves.

Normal clots:

• less than a quarter;
• found only occasionally;
• appear at the beginning of menstruation;
• bright or dark red.

Abnormal clots are larger than a quarter centimeter in size and occur more frequently. The regular occurrence of large blood clots during menstruation may signal a health condition that requires investigation.

See your doctor if you have heavy menstrual bleeding with a lot of clots larger than a quarter in size. Your period is considered heavy if you change your tampon or pad every two hours or less.

You should seek immediate medical attention if you have a period with large clots and you think you might be pregnant. This could be a sign of a miscarriage.

When black discharge requires treatment

Particular care should be taken if dark, almost black periods are accompanied by the following unpleasant sensations:

1. Severe pain in the lower abdomen.
2. Atypical increase in discharge volume.
3. Severe itching and burning in the genital area.
4. Unpleasant menstrual odor.
5. Loss of strength at the beginning of the cycle.
6. Dizziness and headaches.
7. Pallor of the skin.

In addition to changes in menstruation, other symptoms may occur:

• severe hair loss;
• delay and premature onset of monthly discharge;
• bloody clots in leucorrhoea;
• bleeding of unknown origin in the middle of the cycle.

This situation cannot be normal. And the sooner a woman consults a doctor, the greater the chance of avoiding even more serious violations.

What Causes Menstrual Clots?

Most women of childbearing age shed the uterine lining approximately every 28 to 35 days. The endometrium grows and thickens over the course of a month in response to estrogen, the female hormone. Its purpose is to help the fertilized egg implant in the uterus. If pregnancy does not occur, other hormonal events signal the need to shed the unwanted membrane. This is called menstruation. When the endometrium is shed, it damages small vessels, causing bleeding.

Menstrual discharge consists of many elements:

• blood;
• blood by-products;
• slime;
• textile.

This mixture is then expelled from the uterus through the cervix from the vagina. As the mucous membrane is shed, it sinks to the fundus of the uterus, waiting for the cervix to contract and push out the contents. To aid tissue breakdown, the body releases anticoagulants to dilute the material and allow it to pass freely. However, when blood flow outpaces the body's ability to produce anticoagulants, period blood clots are released.

The formation of blood clots is most common with heavy discharge. For many women with normal periods, heavy flow usually occurs early in the period but is short-lived.

Menstruation is considered normal if bleeding lasts 4 to 5 days. During this time, a woman loses 2 to 3 tablespoons of blood or less.

For women with heavy periods, excessive bleeding and blood clots may be prolonged. A third of women have periods so heavy that they soak a pad or tampon every hour.

Possible causes of black spotting

Pathological processes can be provocateurs of dark discharge during or after menstruation. They are provoked by:

Abortion

The sudden removal of a fertilized egg, which has already triggered hormonal changes, negatively affects a woman’s health. For some time, the temporary glands still produce pregnancy hormones, so menstruation may be absent for up to 2–4 months.

You may experience dark or black discharge instead of your period. This condition is not normal, the woman needs to visit a doctor and be examined, perhaps the gynecologist will prescribe hormonal therapy.

Postpartum period

In the first 6–8 weeks after delivery, the uterine cavity is cleansed and lochia is released. They are dark red with clots, but later become pink and watery. Due to the production of prolactin (its function is milk production), menstrual flow temporarily stops. However, upon completion of breastfeeding, scanty spotting may appear during the process of hormonal changes.

Ectopic pregnancy

When the fertilized egg is implanted in the fallopian tubes, the pregnancy test is positive and all the signs of pregnancy are present in the early stages after the delay. However, brown, brown discharge always appears in the early stages of pregnancy. A woman needs to have an ultrasound done, with which the doctor will rule out or confirm an ectopic pregnancy. This condition is life-threatening, therefore, if the hCG test is positive, you must immediately visit a gynecologist and undergo an examination.

Surgical procedures

Surgical interventions on the pelvic organs - removal of fibroids, cesarean section, removal of cysts on the ovaries, etc. During operations, something may not go as planned, doctors may cause an infection or damage something. This happens extremely rarely, but you should report any changes to your doctor.

Features of the development of the genital organs

Congenital anomalies of the shape of the uterus are of two types: bicornuate, saddle-shaped. Such malformations of the internal reproductive organ provoke the secretion of dark mucus during menstruation. This is explained by stagnant processes. This is why periods may not be heavy and black.

Hormonal changes

Instability of hormone levels occurs due to disruption of their synthesis. If such a pathology is suspected, a biochemical blood test should be taken.

Immunodeficiency

A suppressed state of the immune system contributes to the failure of the vaginal microflora and the penetration of infections that provoke a dirty discharge.

Sexual infections

Infection occurs through unprotected sexual contact. In the early stages of the lesion, yellow, green, cloudy shades of discharge are observed. Brown spotting can occur when the upper reproductive organs are affected - the ovaries, fallopian tubes, and uterus. However, this rarely happens; it is usually possible to detect and eliminate the sore in the early stages with the help of antibacterial drugs.

Irregular sex life

Lack of sex has a bad effect not only on men, but also on women. During intimacy, both partners produce hormones. A woman's vagina is capable of absorbing male hormones (androgens), which are contained in sperm. This is how hormonal levels are regulated.

Changes in climate and time zone are a huge stress for a girl’s body, until the body adapts to the new conditions, black discharge appears instead of menstruation.

Heavy physical activity (sports, work), diet.

This problem worries female athletes; due to physical activity, a lack of energy occurs in the body, as a result of which the brain postpones full bleeding until more favorable moments.

Neoplasms in the reproductive system

Black, dark brown blood during menstruation may indicate a polyp in the uterus or a malignant tumor. Atypical growths have the ability to change hormonal levels, provoke bleeding regardless of the cycle and cause severe pain.

You cannot do douching on your own and prescribe treatment for yourself.

Nonspecific inflammatory processes

For various reasons, a woman can develop inflammation in different parts of the reproductive system. They are called nonspecific because their occurrence is not caused by one specific pathogen. The reasons for the development of such pathologies were many factors simultaneously. Such diseases include:

1. Adenomyosis – endometrial cells spread to the muscular layer of the uterus. With this pathology, earthy secretion is observed, sometimes it is not associated with menstruation. Menstruation is very heavy and painful.
2. Endometritis is inflammation of the uterine body. Characterized by dark discharge, regardless of the phase of the cycle. A general intoxication syndrome and severe pain in the lower abdomen appears.
3. Nonspecific salpingitis is inflammation of the uterine appendages (tubes and ovaries). Patients experience: spasmodic pain, cycle disruption, dirty-brown discharge with an unpleasant but faint odor.
4. Endometriosis is a proliferation of cells in the lining of the uterus, most often on the cervix or in the abdominal cavity, this disease depends on the hormone estrogen. Endometriosis is always characterized by the release of dark brown secretions shortly before menstruation.

What are the causes of abnormal clots

Physical pathologies and hormonal factors can cause heavy periods with clots and disrupt the menstrual cycle. Abundant discharge in itself is a prerequisite for their appearance. And the presence of gynecological diseases increases the chances of developing abnormal blood clots.

Bend

If there is a bend in the uterus, women suffer from very heavy periods with clots. The obstruction puts additional pressure on the wall of the uterus, reducing the ability of the uterus to contract. When the uterus does not contract properly, blood accumulates and coagulates inside the uterine cavity, forming pieces that are subsequently removed through the cervix along with the blood.

Myoma

Fibroids are noncancerous, muscle tumors that grow in the wall of the uterus. In addition to heavy bleeding during periods with clots, they can also cause:

• irregular bleeding;
• lower back pain;
• pain during sex;
• protruding belly;
• problems with conception.

After age 50, many women will develop fibroids; the cause is unknown, but genetics and the female hormones estrogen and progesterone likely play a role in their occurrence.

Endometriosis

Endometriosis is a condition in which the lining of the uterus grows outside of the uterus. A clear sign of endometriosis is heavy periods with very large blood clots. During the menstrual cycle, endometriosis also causes:

• painful cramps;
• nausea, vomiting, diarrhea during menstruation;
• discomfort during sex;
• infertility;
• pain in the pelvic area;
• bleeding.

The exact cause of endometriosis is unknown, but heredity, hormones and previous pelvic surgery play a role.

Adenomyosis

Adenomyosis occurs when the lining of the uterus grows into the wall of the uterus for unknown reasons. This causes it to enlarge and thicken. In addition to very heavy periods with clots, this condition can cause the uterus to become two to three times its normal size.

Hormones

Proper growth and thickening of the uterine lining depends on the balance of estrogen and progesterone. If there is too much or too little of one or the other, you may experience heavy menstrual bleeding. What can cause hormonal imbalance:

• menopause;
• stress;
• weight gain or loss.

The main symptom of hormonal imbalance is irregular menstruation. For example, your period may be later or longer than usual, or you may miss it entirely.

Miscarriage

About half of all pregnancies end in miscarriage. Many pregnancy losses occur before a woman even knows she is pregnant. When an early pregnancy is lost, it can result in heavy bleeding, cramping, and clotting of blood clots.

von Willebrand disease

Heavy menstrual flow can also be caused by von Willebrand disease. Between 5 and 24 percent of women with chronic heavy menstrual bleeding have this condition. Von Willebrand disease may be the cause of your heavy periods and period clots. You also bleed easily after a minor cut or your gums bleed after every brushing. Contact your doctor if you suspect this is causing heavy bleeding.

What other reasons for the violation could there be?

For a long period of time, a woman may not even realize that pregnancy has occurred. At first there are no symptoms. The appearance of spotting, similar to menstruation, with black clots may be due to:

• risk of miscarriage;
• ectopic pregnancy.

You will learn about the reasons for the appearance of clots if you watch this video:

During an ectopic pregnancy, a woman needs surgical intervention. Help must be provided immediately. For this, the woman is hospitalized.

Immediately after childbirth, spotting, which contains black clots, is called lochia. The process is aimed at cleansing the uterus after delivery. Gradually the amount of secretion will decrease.

The appearance of abundant clots in menstrual blood occurs after an abortion. Any termination of pregnancy is a real stress for the body.

Another probable cause of the violation is the use of emergency contraception, for example, Postinor. The pill affects hormonal levels and can lead to menstruation irregularities.

Abnormalities are caused by sudden weight gain or loss. This entails changes in the performance of the entire organism.

Sudden weight loss can lead to problems

What complications can there be?

One of the main complications of heavy menstrual bleeding is iron deficiency anemia. Anemia is a condition that occurs when there is not enough iron in the blood to produce healthy red blood cells. Symptoms include:

• fatigue;
• weakness;
• pallor;
• shortness of breath;
• chest pain.

To determine the underlying cause, your doctor will ask you about what might be affecting your period. For example, you have had previous pelvic surgery, used contraception, or were pregnant. In addition, your doctor may order blood tests to look for hormonal imbalances. Imaging tests, such as an MRI or ultrasound, may be used to check for fibroids, endometriosis, or other conditions that are obstructing blood flow.

How are menstrual clots treated?

When it comes to how to stop heavy periods and what can be done about clots, the best answer is to control your bleeding with medications and taking care of your health. In rare cases, when it is necessary to remove fibroids, surgical procedures are resorted to. Talk to your doctor about the pros and cons of all your options for stopping period bleeding.

Hormonal contraceptives

Hormonal contraceptives suppress the growth of the uterine lining. A progestin-releasing IUD can reduce menstrual blood flow by 90 percent, while birth control pills can reduce menstrual blood flow by 50 percent.

Hormonal contraceptives may also be useful in slowing the growth of uterine fibroids and adhesions.

For women who cannot or do not want to use hormones, the drug tranexamic acid, which affects blood clotting, is prescribed. Medications that stop heavy period bleeding, such as Ibuprofen, may be sufficient.

Surgical intervention

Sometimes you may need surgery to get rid of conditions that are causing clots during your period. The cervix is ​​dilated, followed by scraping of the uterine mucosa. This is usually done in an outpatient setting under sedation. Although curettage will not cure heavy bleeding, it does provide a respite for several months as the endometrium then thickens again.

For women with uterine tumors, such as fibroids, that do not respond well to medications, surgery may be necessary to remove them. The type of surgery will depend on the size and location of the lesions.

If the size is large, you will need a myomectomy, which involves a large incision in the abdomen to access the uterus. If the tumor is small, laparoscopic surgery is performed. Laparoscopy also involves making incisions in the abdomen, but they are smaller.

Recovery diet

Treat blood loss with extra fluids and salt. Any time you feel dizzy or have a racing heart when you get out of bed, it's a sign that your blood volume is too low. Drink more salty liquids, such as tomato or other vegetable juices, salty broths. Drink four to six cups (1-1.5 liters) of fluid per day.

Nourish your body with iron to replace what is lost during heavy bleeding.

Start taking one iron tablet (eg 35 mg ferrous gluconate) a day. You should also increase the amount of iron you get from foods - red meat, liver, egg yolks, dark green vegetables and dried fruits such as raisins and prunes are good sources of iron.

How can you stop heavy periods with blood clots?

Medicines

Note! Only a qualified gynecologist, after a thorough examination, will be able to select treatment with pharmaceutical drugs that will correspond to the characteristics of menstruation individually for each woman.

As first aid, every woman's first aid kit should include:

• Etamsylate - this remedy helps stop bleeding without affecting blood clotting. Taking the drug does not contribute to the development of blood clots. The medicine begins to act within 20 minutes, the result lasts for 5-6 hours. Side effects include changes in the gastrointestinal tract and dizziness.
• Pharmaceutical tincture of water pepper – the drug helps accelerate blood clotting, relieves inflammation and stops heavy periods. Contraindications are inflammatory processes in the kidneys and individual intolerance.

• Ascorutin - this drug can be taken for preventive purposes; it strengthens the walls of blood vessels. Do not use for thrombosis and diseases of the genitourinary system in the acute stage.
• Dicinone - can stop bleeding, used for heavy periods. It is recommended to take the drug as prescribed by a doctor, due to possible side effects and allergic reactions.
• Vikasol is an anti-inflammatory drug that helps improve coagulation, has a positive effect when heavy discharge is associated with a lack of vitamin K in the body. Do not use if there is increased blood clotting.

Folk remedies to stop heavy periods

Be careful! You can use folk remedies when menstruation does not cause dizziness, severe pain , or small blood clots, then such bleeding can be stopped with the help of herbs.

An infusion of acorns is considered an effective remedy for stopping heavy menstruation.