Noticing blood clots during menstruation is common and can raise questions about their cause. Uterine fibroids, non-cancerous growths, are often a potential factor. Understanding both can clarify this connection.
What Are Period Clots and Fibroids?
Menstrual blood clots are clumps of blood, tissue, and mucus. They form when menstrual flow is heavy, and blood pools in the uterus or vagina before discharge. The body releases natural anticoagulants to prevent clotting, but during very heavy bleeding, these substances may not keep up, leading to clot formation.
Uterine fibroids, also known as leiomyomas, are non-cancerous growths composed of muscle and fibrous tissue that develop in or on the uterus. They can range in size from as small as a pea to as large as a melon. Fibroids are common, affecting a significant number of women by age 50, though many do not experience symptoms. Their location within or on the uterus can vary, influencing the symptoms they might cause.
How Fibroids Contribute to Clotting
Fibroids can contribute to heavier bleeding and, consequently, larger or more frequent blood clots during menstruation. One mechanism involves the increased surface area of the uterine lining, particularly with submucosal fibroids that protrude into the uterine cavity. This expanded surface area means more lining to shed, resulting in heavier blood flow.
Fibroids can also interfere with the uterus’s ability to contract effectively. The uterus normally contracts to help shed its lining and control bleeding. When fibroids are present, especially intramural fibroids within the muscular wall, they can disrupt these contractions, leading to prolonged and heavier bleeding that is more likely to clot. Additionally, some fibroids develop their own blood vessels or cause dilated blood vessels in the uterine wall, further increasing blood flow and the likelihood of clot formation.
Other Factors Causing Period Clots
While fibroids are a common cause, other conditions can also lead to heavy menstrual bleeding and blood clots. Hormonal imbalances, such as those seen in polycystic ovary syndrome (PCOS), can result in an excessively thick uterine lining. When this thicker lining sheds, it can lead to heavier periods and larger clots because the body’s natural anticoagulants are overwhelmed.
Adenomyosis is another condition where the tissue that normally lines the uterus grows into the muscular wall of the uterus, causing the uterus to enlarge and leading to heavy, painful periods and clots. Endometrial polyps, which are non-cancerous growths of the uterine lining, can also cause abnormal bleeding and clots. Bleeding disorders, certain medications like anti-inflammatory drugs or anticoagulants, and changes in birth control methods can also influence menstrual flow and lead to the presence of clots.
When to Consult a Healthcare Professional
It is advisable to consult a healthcare professional if you experience consistently heavy periods accompanied by large blood clots. Signs that warrant medical attention include soaking through one or more sanitary pads or tampons every hour for several consecutive hours. Passing blood clots that are larger than a quarter is also a reason to seek medical advice.
Prolonged periods lasting longer than seven days, or bleeding between periods, should also be evaluated. Heavy menstrual bleeding can sometimes lead to iron deficiency anemia, which may cause symptoms such as fatigue, weakness, dizziness, lightheadedness, or shortness of breath. Experiencing significant pain that interferes with daily activities also indicates a need for professional diagnosis and guidance.
Diagnosis and Management of Fibroids
Diagnosing fibroids typically begins with a review of your medical history and a pelvic examination, where a healthcare provider might feel an enlarged uterus or masses. Imaging tests are then commonly used to confirm the diagnosis and determine the size and location of fibroids. An ultrasound scan, which uses sound waves to create images of the uterus, is a standard diagnostic tool. Magnetic Resonance Imaging (MRI) may provide more detailed images, helping to differentiate fibroids from other conditions like adenomyosis and to plan for treatment. A hysteroscopy, involving a thin scope inserted through the vagina to view the inside of the uterus, can also be used to identify fibroids within the uterine cavity.
Management of fibroids depends on symptoms, size, location, and individual preferences, including future pregnancy plans. Medications can help manage symptoms like heavy bleeding; these include hormonal birth control, progestin-releasing intrauterine devices (IUDs), and tranexamic acid which helps reduce bleeding. Gonadotropin-releasing hormone (GnRH) agonists and antagonists can temporarily shrink fibroids and reduce bleeding by lowering estrogen levels, though they may have side effects and fibroids can regrow after stopping treatment.
Procedural and surgical options are available for more significant cases. Myomectomy surgically removes fibroids while preserving the uterus, which may be an option for those desiring future pregnancy. Other procedures include uterine artery embolization (UAE), which cuts off blood supply to fibroids, causing them to shrink, and endometrial ablation, which destroys the uterine lining to reduce heavy bleeding. A hysterectomy, the surgical removal of the uterus, offers a permanent solution for fibroids and related symptoms.