Menstrual Clots And Stroke: What's The Connection?

Menstrual clots are a common occurrence during the heaviest days of a person's period. They are a mixture of blood cells, tissue from the uterus lining, and proteins that help regulate blood flow. While small clots are usually nothing to worry about, larger clots may be a cause for concern. Passing clots larger than a quarter in size may indicate an underlying medical condition such as uterine fibroids, endometriosis, adenomyosis, or hormonal imbalances. If you are experiencing heavy menstrual bleeding or large clots, it is recommended to consult a healthcare professional.

Menstrual clots are usually a natural part of the body's defence mechanism

Menstrual clots are a natural part of the body's defence mechanism. They are a mixture of blood cells, tissue from the uterus lining, and proteins in the blood that help regulate its flow. The thick, jelly-like texture of a menstrual clot helps prevent too much blood from escaping. This is similar to the clotting function that happens elsewhere in the body in response to an injury, such as a cut.

During menstruation, the endometrial cells that line the uterus are shed. As this happens, the body releases proteins that cause the blood in the uterus to coagulate. This coagulation prevents the blood vessels in the uterine lining from continuing to bleed. When the flow is most substantial, the coagulation proteins within the blood may start to clump together, resulting in menstrual clots. This generally occurs when menstrual blood pools in the uterus or vagina before leaving the body.

Menstrual clots are typically experienced during the heaviest days of a period, which is usually the first 2 days of menstruation. They are more likely to occur when there is heavy blood flow, as the blood pools in the uterus before exiting the cervix. This is why clots are often a darker, deeper red, or even black, as the blood is older and has been in the uterus for longer.

Menstrual clots are usually nothing to worry about. They are a normal part of the menstrual cycle and are the body's way of preventing excessive blood loss. However, if you experience very large clots (larger than a quarter) or pass an excessive number of clots, it may be a sign of an underlying medical condition. Heavy menstrual bleeding can be a symptom of uterine fibroids, endometriosis, adenomyosis, hormonal imbalances, bleeding disorders, or pregnancy-related issues such as miscarriage or ectopic pregnancy. Therefore, it is important to seek medical advice if you have concerns about the size or frequency of your menstrual clots or if you are experiencing other symptoms alongside them.

Passing large clots may be a sign of an underlying medical condition

Passing large clots during your period could signal a medical condition that needs investigation.

Menstrual clots are a mixture of blood cells, tissue from the uterus lining, and proteins in the blood that help regulate its flow. While passing smaller clots is usually nothing to worry about, regularly passing clots that are larger than a quarter may indicate an underlying medical condition.

Uterine Obstructions

Conditions that enlarge or engorge the uterus can put extra pressure on the uterine wall, increasing menstrual bleeding and clots. Uterine obstructions can be caused by fibroids or endometriosis. Fibroids are typically noncancerous, muscular tumours that grow in the uterine wall. Endometriosis is a condition in which cells that resemble the uterus lining grow outside the uterus and into the reproductive tract.

Hormonal Imbalances

A balance of hormones is essential for maintaining a healthy uterus. If the levels of specific hormones become unbalanced, issues such as heavy menstruation or clotting can occur. Hormonal imbalances can be caused by significant weight gain or loss, stress, or extreme exercise.

Bleeding Disorders

Some bleeding disorders, such as platelet function disorder or von Willebrand's disease (VWD), may cause abnormally heavy menstruation. VWD is rare, but it is estimated that between 5 and 24 percent of women with chronic heavy menstrual bleeding are affected by it.

Pregnancy-Related Issues

During a miscarriage or pregnancy loss, it is common to pass some large clots, depending on the stage of the pregnancy. Pregnancy loss can sometimes occur before a person knows they are pregnant, so they may mistake an early miscarriage for a regular menstrual cycle. An enlarged uterus after pregnancy or due to structural issues, such as fibroids, can also lead to more space for blood to pool and form clots.

If you are passing large clots during your period, it is advisable to seek medical advice, especially if you are experiencing heavy bleeding, significant pain, or other concerning symptoms. Your doctor will be able to investigate the underlying cause and recommend appropriate treatment options.

Heavy menstrual bleeding may lead to iron deficiency anaemia

Heavy menstrual bleeding, also known as menorrhagia, is a highly prevalent issue for women of reproductive age. It is a major contributor to iron deficiency and its most severe manifestation, iron deficiency anaemia. The interrelationship between heavy menstrual bleeding and iron deficiency is often poorly understood and frequently normalized by society, healthcare providers, and affected women themselves. However, it is important to recognize that both conditions can adversely impact the quality of life of women, from menarche to menopause. Heavy menstrual bleeding can affect women during episodes of bleeding, while iron deficiency can impact them on a daily basis.

The effects of iron deficiency on cognitive function can lead to work and school absenteeism, undermining the efforts and function of women in various roles, such as students, educators, employers, or employees. Additionally, there is growing evidence that iron deficiency during early pregnancy may negatively impact fetal neurodevelopment, leading to enduring effects on cognitive and psychological disorders. This highlights the critical importance of addressing iron deficiency in reproductive-aged women.

Heavy menstrual bleeding can lead to iron deficiency anaemia due to excessive blood loss. When there is a significant loss of blood during menstruation, the body may not be able to produce enough red blood cells to compensate. Red blood cells contain haemoglobin, a protein that carries oxygen from the lungs to all parts of the body. Iron is essential for the production of haemoglobin. Therefore, when there is a reduced amount of iron in the body due to heavy menstrual bleeding, it can result in iron deficiency anaemia.

The symptoms of iron deficiency anaemia include feeling weak or tired during the period and difficulty performing normal daily activities. Additionally, individuals with low levels of iron and haemoglobin in their blood may exhibit pale or yellowish skin. Heavy menstrual bleeding is considered a risk factor for iron deficiency anaemia, and it is important to seek medical advice if these symptoms are present.

To diagnose iron deficiency anaemia, a healthcare provider will take a medical and family history, perform a physical examination, and may conduct a pelvic exam if heavy menstrual bleeding is present. A complete blood count test is typically used to confirm the diagnosis, as it can measure red blood cell levels and iron storage in the body.

Treatment options for iron deficiency anaemia caused by heavy menstrual bleeding depend on the underlying cause of the heavy bleeding. Hormonal birth control, iron supplements, and dietary changes to include more iron-rich foods may be recommended. In severe cases, surgery may be necessary to address the cause of the heavy bleeding, such as uterine artery embolization, focused ultrasound surgery, endometrial ablation, or a hysterectomy.

Uterine obstructions can cause increased menstrual bleeding and clots

Uterine fibroids are noncancerous, muscular tumours that develop in the uterine wall. They are a common cause of uterine obstruction, affecting 80% of females by the age of 50. Fibroids can lead to heavy menstrual bleeding and irregular menstrual bleeding. Endometriosis is another condition that can cause uterine obstruction. It occurs when endometrial cells, which resemble the uterine lining, grow outside the uterus and into the reproductive tract. Endometriosis can cause painful, crampy periods, nausea, vomiting, and abnormal bleeding, which may include clotting. Adenomyosis is a third condition that can lead to uterine obstruction. It involves the uterine lining growing into the uterine wall, causing the uterus to enlarge and thicken. This can result in prolonged, heavy bleeding and an increase in the size of the uterus.

While uterine obstructions can cause increased menstrual bleeding and clots, it is important to note that there are other factors that can contribute to heavy menstrual bleeding, such as hormone imbalances, pregnancy complications, and the use of an intrauterine device. Additionally, certain diseases, such as thyroid, kidney, or liver disease, cancer, or bleeding disorders, can also lead to heavy bleeding.

If you are experiencing heavy menstrual bleeding or clots larger than a quarter, it is recommended to consult a healthcare professional for further evaluation and guidance.

Medications, such as anti-inflammatory drugs, can contribute to abnormal menstrual flow and bleeding

NSAIDs are more effective than a placebo in reducing heavy menstrual bleeding but are less effective than tranexamic acid, danazol, or the levonorgestrel-releasing intrauterine system (LNG IUS). NSAIDs are considered useful for women who do not desire contraception, especially those with painful menstrual periods.

NSAIDs can have adverse gastrointestinal effects, and so it is important to consider individual responses to different medications. For example, mefenamic acid is less likely to cause gastrointestinal issues than naproxen. NSAIDs are contraindicated for women with heavy menstrual bleeding and an underlying bleeding disorder because of their inhibitory effect on platelet aggregation.

Hormonal contraceptives are another medication option for treating heavy menstrual bleeding and can inhibit the growth of the uterine lining. They can also be beneficial in slowing the growth of fibroids and other uterine adhesions. Oral contraceptives can be used to skip periods entirely and reduce the risk of ovarian and endometrial cancer by about 50%. However, they may cause side effects such as nausea, breast soreness, headaches, and changes in sex drive or libido.

Tranexamic acid is another medication that can be used to treat heavy menstrual bleeding. It helps the blood to clot, reducing bleeding. It is often taken during a period and can be combined with NSAIDs for increased effectiveness.

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