Why do blood clots form during menstruation?
Blood clots form naturally in response to increased menstrual bleeding. “During your period, your body secretes anticoagulants to prevent the blood leaving the uterus from clotting. But if you have a very heavy flow, blood may leave the uterus faster than the anticoagulants can kick in, causing a clot to form,” says Dr. Srivastav. It’s a natural process, and the occasional small clot is usually harmless.
However, if you frequently pass large blood clots, your menorrhagia may be due to something else. Hormonal fluctuations, structural abnormalities of the uterus, and certain health conditions can all affect the formation of blood clots during menstruation.
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Common Causes of Blood Clots During Menstruation
Dr. Srivastav explains that there are many factors that contribute to severe bleeding and blood clot formation. These factors include:
1. Hormonal imbalance
Estrogen (a hormone essential for the development and maintenance of female sexual health) and progesterone (in the endometrium, or inner lining of the uterus, which houses and develops a fertilized egg) help regulate the menstrual cycle. An imbalance of these hormones can cause heavy periods and blood clots.
In particular, excess estrogen can thicken the lining of the uterus and cause increased menstrual bleeding. A study published in the journal Cureus highlights that elevated estrogen levels are often associated with menorrhagia, which may lead to an increased frequency of blood clots.
2. Uterine fibroids and polyps
Uterine fibroids are benign, noncancerous tumors in the uterus, while polyps are smaller, benign tumors in the endometrium. Both can increase menstrual bleeding and lead to the formation of blood clots. According to a study published in Frontiers in Pharmacology in 2017, women with uterine fibroids often report heavy menstrual bleeding, which may contribute to frequent blood clots.
3. Endometriosis
Endometriosis occurs when tissue from the lining of the uterus grows outside the uterus, causing heavy and painful periods that are often accompanied by blood clots. A review by StatsPearls highlights that endometriosis, especially in severe cases, is strongly associated with heavy menstrual flow and blood clots.
4. Polycystic Ovary Syndrome (PCOS)
PCOS is a hormonal disorder that can disrupt your menstrual cycle and cause heavy bleeding. People with PCOS may not menstruate as often, but when they do menstruate, the flow is heavier and more likely to clot. Another study published in StatPearls found a strong link between PCOS and irregular, heavy bleeding caused by hormone imbalances.
5. Endometriosis
Adenomyosis is a condition in which the endometrium grows into the muscular wall of the uterus, which can cause severe menstrual pain accompanied by blood clots. Studies have shown that menstrual pain is frequently accompanied by an increased rate of blood clots, including one of Thiem’s adenomyosis conditions.
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What do menstrual blood clots indicate?
While small blood clots are normal, very large clots or a sudden change in your menstrual cycle could indicate an underlying health problem. According to Dr. Srivastav, some signs you should see a healthcare professional include:
- Large or frequent clots (larger than a quarter)
- Heavy, persistent bleeding that requires frequent changes of pads or tampons
- Sudden changes in the menstrual cycle (including increased blood clots)
- Severe pain accompanied by blood clots
If you experience any of these symptoms, a medical evaluation can rule out conditions such as uterine fibroids, endometriosis, or hormonal imbalances.
Prevention tips to reduce blood clot formation
While it may not be possible to prevent all blood clots, certain lifestyle and dietary changes can help control severe bleeding and reduce the formation of blood clots.
- Maintain a healthy weight
- Eat foods high in iron
- Stay hydrated
- Stress management
- Consider a balanced diet that includes anti-inflammatory foods
When should I see a doctor?
If blood clots during your period appear more frequently or are accompanied by severe pain or other unusual symptoms, see your healthcare provider. Treatment may include hormone therapy, medications to control bleeding, or lifestyle recommendations. Other treatments, such as surgery, may be recommended for structural problems like uterine fibroids, polyps, or endometriosis.
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Understanding the factors that contribute to blood clot formation and adopting healthy lifestyle habits may help you better control and reduce your menorrhagia. And remember, if your blood clots are accompanied by discomfort or other symptoms, your healthcare provider can make sure something more serious isn’t happening and provide appropriate treatment if needed.
