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Menstrual health: What you need to know about period blood clots
Summary
Menstrual clots can be a normal part of your cycle, but they may also signal underlying health issues. Here's a guide to understand the condition and manage your menstrual health effectively
A healthy menstrual cycle involves the brain, ovaries and uterus working in close harmony, to facilitate the development of an egg and the endometrium lining of the uterus, in anticipation of a possible pregnancy. In the absence of pregnancy, the endometrial lining is discarded by the body in the form of menstrual flow. While menstrual flow typically passes freely through the cervix and leaves the body, there are times when the flow is interrupted by menstrual clots, which are lumps of coagulated blood or tissue. While the presence of some clots can be considered normal, they can also signal to the presence of a more pressing underlying medical concern.
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Understanding the role of hormones
Hormones essay a central role in the menstrual cycle, particularly in its regulation. In the beginning of the cycle, the follicle stimulating hormone (FSH), which is produced in the brain’s pituitary gland, induces the formation of an egg. Nearly halfway through the cycle, a surge of oestrogen causes the uterine lining to thicken, to facilitate the implantation of a fertilised egg. Once the oestrogen levels are sufficiently high, a surge of luteinising hormone (LH) triggers ovulation, during which the egg matures and is released. As the ovulation cycle begins, the progesterone level rises to help make the uterine lining stable for a potential pregnancy. If fertilisation doesn’t occur, the oestrogen and progesterone levels recede, which leads to menstruation.
Menstrual clots decoded
While the body typically produces anticoagulants or blood thinners as part of the menstrual cycle, there are times when the menstrual blood coagulates before leaving the body. Occasional clots are normal, however, very frequent clotting or the presence of very large clots could be a cause for concern.
The most common reason for excessive clotting is hormonal imbalance, such as high oestrogen or low progesterone, often observed in individuals diagnosed with PCOS or obesity. Other causes include:
- Fibroids: Submucosal fibroids increase the blood supply and decrease the normal expulsion of the endometrial tissue from the uterus.
- Endometriosis and adenomyosis: Conditions where uterine-like tissue grows outside the uterus or within its walls, causing clotting.
- Pregnancy-related issues: Certain conditions, including miscarriage, can result in clots being formed.
- Blood clotting disorders: Conditions such as Willebrand Disease or thrombophilia can impair the body’s ability to regulate clotting, leading to more significant clot formation during menstruation.
- Medications and devices: Anti-coagulants, certain hormonal treatments and intrauterine devices (IUDs) can influence menstrual flow and clotting patterns.
Also read: Managing PMS: Coping strategies for the days leading up to your period
When should you consult a doctor?
While some clotting is normal, be mindful of the following warning signs that could indicate a more serious underlying condition:
- If the clotting is very frequent and the clots are larger than the size of a rupee coin.
2. Heavy periods in excess of seven days, which require you to frequently change your sanitary products.
3. Extreme pain and discomfort could point to the presence of fibroids, endometriosis or severe PCOS.
4. Irregular menstrual cycle, including sudden changes in flow and/or duration, accompanied by clots.
5. Fatigue and dizziness, which may be indicative of anaemia. Shortness of breath may also indicate significant blood loss.
How to manage and prevent menstrual clots
In addition to addressing the underlying cause of abnormal bleeding, certain lifestyle changes can help regulate hormonal imbalances that may be responsible for menstrual clots:
- Maintaining a healthy body weight (BMI)
- Stress relief strategies, such as meditative practices
- Eating a nutritious and balanced diet
4. Your doctor may prescribe oral contraceptive pills, patches or IUDs to address hormonal imbalances. Nonsteroidal anti-inflammatory drugs (NSAIDs) may be used to mitigate severe pain and a very heavy flow. Surgery is an option for extreme instances. Importantly, regular gynaecological examinations can ensure early detection of any irregularities and timely interventions.
Dr. Rohan Palshetkar is the head of Unit Bloom IVF, and professor – Dept. of OBGy, DY Patil School of Medicine, Navi Mumbai.
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