Endometriosis is a condition where tissue similar to the lining inside the uterus grows outside of it, often on organs like the ovaries, fallopian tubes, and the outer surface of the uterus. A common concern for individuals with endometriosis is the presence of large blood clots during menstruation.
How Endometriosis Contributes to Blood Clots
Endometriosis often causes heavy menstrual bleeding. When menstrual flow is heavy or prolonged, the body’s natural anticoagulants, which prevent excessive clotting, can become overwhelmed. Blood can then pool and coagulate within the uterine cavity, forming larger clots that are expelled.
The chronic inflammation associated with endometriosis also plays a role. This tissue reacts to hormonal changes, causing bleeding and inflammation. This inflammatory process can alter blood clotting mechanisms, contributing to a hypercoagulable state. Research indicates that individuals with endometrioma, a type of endometriosis, may show elevated levels of coagulation factors like fibrinogen, promoting clot formation.
Severe pain and uterine contractions, common symptoms of endometriosis, might also influence the expulsion of larger clots. When the uterus contracts intensely to expel the thickened lining, rapid expulsion can lead to less time for blood to remain liquid, forming larger clots. High estrogen levels, often linked to endometriosis, can also contribute to a thicker uterine lining, leading to heavier bleeding and larger clots when shed.
Identifying Large Blood Clots
Menstrual blood clots are masses of coagulated blood, typically mixed with tissue and mucus from the uterine lining. While passing small, dark red clots is generally considered a normal part of menstruation, larger clots can signal a heavier-than-usual flow. These larger clots often appear as dark red, thick, or jelly-like clumps.
Clots can vary in color, starting bright red and turning darker as the blood ages before exiting the body. The presence of clots larger than a quarter indicates abnormally heavy bleeding.
Other Reasons for Large Blood Clots
While endometriosis can contribute to large blood clots, other conditions also cause heavy menstrual bleeding and significant clots. Uterine fibroids, non-cancerous growths, are a common cause. These growths can distort the uterine cavity or interfere with the uterus’s ability to contract effectively, leading to increased bleeding and clot formation.
Adenomyosis, a condition where the uterine lining tissue grows into the muscular wall of the uterus, can also lead to heavy, prolonged periods with large clots. This causes the uterus to thicken and enlarge, resulting in more tissue to shed and heavier bleeding. Hormonal imbalances, such as those seen in polycystic ovary syndrome (PCOS), can cause the uterine lining to become too thick, leading to heavy and prolonged bleeding with clots when shed.
Causes also include certain bleeding disorders, such as von Willebrand disease, which affect the blood’s ability to clot properly. Other factors like certain medications (e.g., blood thinners) or pregnancy complications can also result in heavy bleeding and large clots.
When to Consult a Doctor
It is advisable to consult a healthcare provider if you experience large blood clots during your period, especially if they are consistently larger than a quarter. Seeking medical attention is also recommended if menstrual bleeding is so heavy that it requires changing a pad or tampon every hour for several hours in a row. This level of bleeding can lead to significant blood loss.
Symptoms of anemia, such as persistent fatigue, weakness, shortness of breath, dizziness, or pale skin, also warrant a medical evaluation, as heavy periods can deplete the body’s iron stores. Any severe or worsening pelvic pain, or new and concerning changes in your menstrual patterns, should prompt a discussion with a doctor to determine the underlying cause and appropriate management.