Heavy uterine bleeding and blood clots occur for many women each month during their menstrual cycle. The severe form of this condition, also referred to as menorrhagia, can cause significant amounts of blood loss. The average menstrual flow lasts four to seven days and occurs about every 28 days, but can vary between women, according to MedlinePlus. Heavy bleeding during a menstrual period can occur for various reasons and several treatment options are available to help slow the flow.
Causes
Several medical conditions can cause heavy menstrual bleeding and blood clots. An imbalance in female hormones such as progesterone and estrogen can alter the cycle. With an imbalance in these hormones, excessive amounts of lining in the uterus build and shed during the menstrual period. Benign tumors in the uterus, called uterine fibroids, can cause excessive menstrual bleeding. Bleeding disorders such as von Willebrand's disease can cause heavy bleeding due to a decreased ability to clot blood. Medications, polyps and an intrauterine device---used to prevent pregnancy---can cause heavy menstrual bleeding, according to MayoClinic.com.
Symptoms
Heavy menstruation includes periods that last longer than seven days and bleeding heavy enough to require changing a tampon or pad at least hourly for several hours, according to The American College of Obstetricians and Gynecologists. Some women pass blood clots without a problem during a menstrual period. The clots can vary in size and can occur during heavy bleeding. Passing blood clots larger than a fist requires an evaluation by a physician. Blood clots may also cause cramping in the uterus.
Diagnosis
To diagnose heavy bleeding and blood clots and to find an effective treatment, a physician completes a physical exam, including a pelvic examination. Taking a history from the patient about the pain, cycle length and the extent of the bleeding helps complete the diagnosis. Ultrasound scans, a biopsy of the lining of the uterus and blood tests can help determine the cause of the bleeding.
Treatments
Treatment for the condition varies depending on the cause of the heavy bleeding. To treat excessive menstrual bleeding, a physician may prescribe large doses of nonsteroidal anti-inflammatory drugs such as ibuprofen to help decrease menstrual flow. These medications block prostaglandins---chemicals that stimulate uterine contractions and blood clotting---in the body and help reduce inflammation and pain. Taking birth control pills may help reduce heavy bleeding because they help regulate the hormones in the body. An endometrial ablation burns out the lining of the uterus and can significantly reduce menstrual bleeding. This treatment is only available for women who do not wish to get pregnant in the future.
Complications
Complications of heavy bleeding include a risk for anemia. Women who lose large amounts of blood during a menstrual period can have low levels of iron in the body. Heavy bleeding and blood clots can cause painful menstrual cramping.
References
- MayoClinic.com: Menorrhagia (heavy menstrual bleeding)
- MedlinePlus: Menstrual periods - heavy, prolonged, or irregular
- The American College of Obstetricians and Gynecologists: Menstrual Periods
- The American Congress of Obstetricians and Gynecologists: Menstruation
- MayoClinic.com: Is it normal to pass large blood clots during menstruation?
