For Chronic Abnormal Uterine Bleeding
Hormonal medication
- 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.
Non-hormonal medication:
- Antifibrinolytics: Tranexamic acid 1 g tds for 35 days, and/or
- NSAIDs: Ibuprofen 400mg tds for 34 days.
What Are The Complications Related To Large Menstrual Clots
If you are having unusually large period blood clots and that too frequently, you should see a doctor about that. A side effect of heavy bleeding and menstrual clots is iron deficiency anemia. Anemia occurs when there is insufficient iron in your body, and no healthy red blood cells can be produced because of it. Some symptoms of anemia are:
What Causes Period Blood Clots
So, why do period blood clots form? Essentially, its all related to your body being incredibly clever. To stop you from losing too much blood during your period, the plasma and platelets in your blood join forces to create blood clots that form in your uterus this is completely normal. It also explains why youre more likely to get period blood clots alongside heavy bleeding: Your body is working hard to prevent excessive bleeding by creating the clots.
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How Is Heavy Menstrual Bleeding Treated
Treatment depends on whats 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 Drugslike 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 isnt 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
Period Blood Clots: The Takeaway
Experiencing blood clots while on your period isnt uncommon, and usually, its not a cause for concern. Even if blood clots during a period are accompanied by some pain, there isnt necessarily any need to worry.
However, there are certain situations in which you may want to start logging your blood clots with your periods. This could relate to blood clot size or other symptoms you may be experiencing, like those associated with heavy bleeding or anemia.
If youre worrying about questions such as how many blood clots are normal during my period? it might help to start tracking your menstrual symptoms and cycles. You can use a period tracker like Flo since you can note down flow intensity and log any premenstrual syndrome symptoms on it. This helps you understand what typical looks like for you and means you can clock any changes to your period from one month to the next.
Experts recommend that you see a doctor for blood clots during a period if youre experiencing excessive bleeding or if your period is accompanied by pain that gets in the way of daily activities. Your doctor should be able to reassure you if you have any concerns by prescribing medications and ruling out any other issues that may be causing blood clots during your period.
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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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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 symptoms of menorrhagia 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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Are Blood Clots In Your Period Normal
Its that time of the month. While changing your pad, tampon or menstrual cup, you might notice you have some blood clots in your period blood. You may wonder if thats normal. Occasionally having blood clots in your period blood is entirely normal. But if you are consistently experiencing clotting or noticing large blood clots, this can be a sign of another underlying condition, and it may be time to talk to your doctor. Here is what you need to know about menstrual blood clots.
Is Heavy Menstrual Bleeding Serious
Heavy menstrual bleeding can be serious if you lose so much blood that you show signs of anemia. Anemia is a condition arising from having too little iron in your body. Anemia can be life-threatening without treatment.
Also, some of the conditions that can cause heavy period bleeding, like cancer, require early medical intervention. Speak with your healthcare provider to discuss any risks related to your period bleeding.
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How Big Should Period Clots Be
For the most part, period clots are a completely normal part of menstruation, Mary Jane Minkin, M.D.,3 a clinical professor of obstetrics and gynecology and reproductive sciences at Yale Medical School, tells SELF.
But if youre seeing clots the size of a quarter or larger, you should visit your doctor, according to the Centers for Disease Control and Prevention .4
If someone is passing quarter-size clots, that tells me that there could be something wrong the uterus that needs further investigation, Dr. Ruiz says. You can even take a picture of what youre seeing so that your doctor can look during your visit. It helps show me the magnitude of whats been going on, Dr. Ruiz says.
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Infographic Excerpt: Underlying Health Conditions That May Lead To Large Blood Clots During Periods
While clotting during the menstrual cycle is normal and expected, in some cases, it may be a sign of an underlying health condition, especially if the clots are bigger than a quarter, frequent, and accompanied by heavy menstrual flow. Check out the infographic below to know more about the health conditions that may cause larger-than-usual blood clots during periods.
Illustration: StyleCraze Design Team
Blood clots during periods can have many causes. These include fibroids, endometriosis, and hormonal imbalances. Certain home remedies can help manage blood clots during periods. Using red raspberry leaf, pumpkin seeds, chamomile tea, cold compress, vitamins, blackstrap molasses, cayenne pepper, ginger tea, and pumpkin seeds can minimize blood clots. In addition, you can possibly prevent blood clots by consuming foods rich in vitamin C, hydrating adequately, and exercising regularly. Also, limiting foods rich in vitamin K is recommended.
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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*
It’s 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. It’s 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.
Are Blood Clots Normal During Periods
In most cases, occasionally passing small menstrual blood clots is considered normal and nothing to worry about. However, passing large clots, especially when accompanied by other symptoms like heavy bleeding, severe cramps, and low energy levels, can signal that something is wrong.
One common underlying health condition that may explain your period blood clots is the presence ofuterine fibroids. Fibroids are non-cancerous growths that develop within or on your uterus. An estimated 70 to 80 percent of women develop fibroids by age 50.
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How Are The Causes Of Menstrual Causes Clots Diagnosed
To effectively diagnose the cause of abnormal menstrual clots, the doctor will ask you questions about some factors that might be responsible for them. For instance, you might be questioned about any history of pelvic surgery, use of birth control, or past pregnancy. In such cases, uterus examination becomes all the more necessary.
Your doctor might conduct a blood test to check for any hormonal fluctuations. An MRI or ultrasound can also be conducted to check for the presence of any fibroids, tumors, endometriosis, etc.
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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Why Did My Period Get Heavy All Of A Sudden
A sudden heavy period may be the result of normal hormonal fluctuations or a side effect of birth control. However, heavy periods can also indicate an underlying health condition. A person should talk to their doctor if they experience heavy bleeding or cramping that prevents them from completing normal activities.
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 Painful Periods And Heavy Bleeding
Signs and symptoms of heavy menstrual bleeding include:
- Bleeding for more than seven days
- Bleeding that soaks through one or more tampons or pads every hour for several hours in a row
- Need to use multiple pads to control menstrual flow
- Need to change pads or tampons during the night
- Menstrual flow with blood clots larger than a quarter
- Flooding of clothing and bedsheets with menstrual bleeding
- Symptoms of anemia, such as fatigue and shortness of breath
Symptoms of menstrual pain include:
- Lower back pain
- Pain that starts a few days before the period, worsens during the period, and lasts two to three days after the period ends
- Throbbing or cramping pain in the lower abdomen that can be intense
- Lower back pain during menses
Patients should see their doctors if:
- Their periods stop for more than 60 days
- Their periods become erratic
- They have any vaginal bleeding after menopause
- They suddenly get a fever and feel sick after using tampons
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Vaginal Infections In Women
What are vaginal infection symptoms?
Abnormal discharge like greenish yellowish discharge, yellowish smelly discharge or thick white discharge with odor are symptoms of vaginal infections. Others are vaginal itching, vulva sore, fever, abdominal pain and body weakness.
You should inform your doctor if you have these symptom. Vaginal discharge samples are collected and tested for the cause. Treatment with antibiotics will follow after testing your blood and vaginal discharge with good success rate.
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How Should You Treat Period Blood Clots
If youre finding it difficult to soothe any pain associated with period blood clots, or theyre interfering with your life, then treatments are available, but you need to determine whats causing the clots first. Your doctor can help determine this by talking through your medical history with you. They may also need to do some extra tests, such as physical examinations, scans, blood work, and hormone checks.
Dr. Twogood gives the following examples of possible medical treatments for period blood clots that your health care provider may bring up in conversation with you:
- Hormonal medications, such as birth control pills
- Hormonal intrauterine devices
What Does Having Large Blood Clots During Period Mean
While small clots are considered normal, large period blood clots are not something to be avoided. Large blood clots are the results of extremely heavy flow during the periods. If your period flow is often heavier than normal, then visit your doctor.
Heavy menstrual bleeding, medically known as menorrhagia mostly affects girls who have just started menstruating or women who are approaching menopause.
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What Causes Heavy Periods With Blood Clots
According to the CDC, Menorrhagia is one of the most common problems women report to their doctors. It affects more than 10 million American women each year. Despite heavy bleeding being so prevalent, most women are not aware that they can get help to manage it. Some are too embarrassed to even bring it up. But being open with your doctor about periods is crucial for ensuring accurate diagnoses.
Is heavy menstrual bleeding a concern for you? Are your periods disrupting your everyday life? It may help for you to speak with a gynecologist about treatment options. Read on to learn about what causes blood clots during menstruation, and the possible underlying health implications.
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.
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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.
The Bottom Line: Your Menstrual Cycle Can Tell You A Lot About Your Health
Thankfully, period tracking apps make it a cinch to stay on top of your cycle length as well as symptoms like cramping, headaches, and flow intensity. Get to know your body and find a gynecologist you feel comfortable seeing if issues arise.
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