Many women bleed clots during heavy menstruation, and that's normal. The body normally releases anticoagulants that prevent blood clots. However, when menstrual bleeding is heavy, the anticoagulants don't have enough time to work, so large blood clots form. Large blood clots are usually the result of periods with excessive bleeding. So, to prevent clots, you must address the bleeding problem.
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Part 1 of 3: Diagnosing Excessive Bleeding and Clotting
Step 1. Watch for blood clots to clot
One of the main signs of excessive menstrual bleeding (also called menorrhagia) is a blood clot. For this diagnosis, a blood clot the size of a coin or larger is considered to be associated with excessive bleeding. Check pads, tampons, and the toilet for lumps.
- The clots look like regular menstrual blood, except that they are denser, somewhat jelly-like.
- Small lumps are normal, and you shouldn't worry.
Step 2. Pay attention to how often you change pads or tampons
If you change pads or tampons more than every 2 hours, you are bleeding profusely. Worries about heavy menstruation and the possibility of penetrating will also interfere with daily activities.
For example, if you change your pad or tampon every hour (for a few hours) and it's full each time, that's excessive bleeding
Step 3. Pay attention to the length of your period
Generally, menstruation lasts 3 to 5 days although 2 to 7 days is still considered normal. If your period lasts longer than 10 days (and continues to bleed), it's a sign of excessive bleeding.
Step 4. Watch for cramps
Cramps are also a sign of excessive bleeding. As already mentioned, a large blood clot is a symptom of excessive bleeding. These lumps are difficult to remove, causing cramps. So, if you feel cramping, it could be a sign of excessive bleeding.
Step 5. Watch for signs of anemia
Anemia occurs when there is not enough iron in the blood. This condition is often experienced by people who have lost a lot of blood. Usually, the main symptom of anemia is feeling tired, lethargic, and weak.
"Anemia" can actually refer to any type of vitamin deficiency, but the most common in menstrual problems is iron deficiency
Part 2 of 3: Consult a Doctor
Step 1. Write a list of symptoms
Before seeing a doctor, you should prepare in advance. Make a list of the symptoms you are experiencing as specifically as possible. Don't be shy, doctors are used to treating various conditions.
- For example, you might write, "Blood profusely (when it's profuse, bleeding from the pad every 3 or 4 hours), more cramping, blood clots the size of a coin, feeling weak and tired, period lasts 12 to 14 days." Counting the number of pads or tampons used can also help.
- You should also take note of major life changes, such as important events that cause stress, as well as sudden weight gain or loss.
- Ask your family if anyone has the same problem as you because menstrual problems can be genetic.
Step 2. Ask for a blood test to check for anemia
If you think you have anemia, ask your doctor to do a blood test. Blood tests can determine the level of iron in the blood. If your iron level is low, your doctor will recommend increasing your intake of iron in your diet and in the form of supplements.
Step 3. Prepare for a physical exam
Usually, the doctor will perform a physical exam to help diagnose the problem, including a pap smear. A Pap smear is done by taking a small amount of cells from the cervix for later analysis.
- The doctor may also take tissue from the uterus for a biopsy.
- You may also need an ultrasound or a hysteroscopy. In a hysteroscopy procedure, a small camera is inserted into the uterus through the vagina so the doctor can see the problem.
Part 3 of 3: Coping with Excessive Bleeding and Clotting
Step 1. Ask about using NSAIDs (nonsteroidal anti-inflammatory drugs)
NSAIDs are a class of pain relievers that include ibuprofen and naproxen. NSAIDs can help relieve pain associated with excessive bleeding. In addition, these drugs can also reduce the amount of blood that comes out during menstruation and help reduce clots.
However, if you are taking NSAIDs, watch for an increase in bleeding as some women experience it as a side effect
Step 2. Consider oral contraceptives
Doctors often prescribe oral contraceptives in cases of excessive bleeding during menstruation. Oral contraceptives can make your periods more regular, but also reduce the amount of blood that comes out and in turn reduce clots.
- Excessive bleeding and blood clots are sometimes caused by hormonal imbalances, and oral contraceptives help balance hormones in the blood.
- Other types of hormone pills are also effective, such as progesterone pills, as well as some types of hormone-releasing IUDs.
Step 3. Consult about tranexamic acid
This medicine can reduce menstrual blood flow. You only need to take it during menstruation, not for a month like the contraceptive pill. When the amount of blood decreases, clots also decrease.
Step 4. Discuss the operation if other options don't work
If medication can't help, surgery may be the remaining option. In a dilation and curettage (D&C) procedure, the doctor will remove the top layer of the uterus, which is part of the uterine wall, to help relieve bleeding and reduce clotting. In an endometrial ablation or resection procedure, more of the lining of the uterus is shed.
- Another option is a hysteroscopy, which allows the doctor to view the inside of the uterus with a small camera, then remove small amounts of fibroids and polyps, and treat other problems that can also reduce bleeding.
- The last option is a hysterectomy to remove the uterus.
