Prolonged Menstrual Bleeding and Blood Clots: When to Seek Help

Prolonged menstrual duration, heavy menstrual flow, and the presence of blood clots?

It has been seven days since the onset of menstruation, with a heavier flow and varying sizes of blood clots.
The menstrual blood is bright red, and there is no abdominal pain.
I would like to know if this amount of menstrual blood and the presence of numerous blood clots are normal, as I have not experienced this level of bleeding or clotting before.
If this heavy bleeding and clotting continue, how long should I wait before seeking medical evaluation? The blood and clots are sometimes expelled suddenly and other times flow gradually.
I also want to understand why there are so many blood clots.

Hui, 20~29 year old female. Ask Date: 2017/03/10

Dr. Zhang Kunmin reply Obstetrics and Gynecology

There have been too many similar questions.
Please refer to our frequently asked questions.

Hello, the reasons for heavy menstrual bleeding in women may include hormonal imbalances, emotional factors, diet, age, and more.
However, the most important thing is to rule out the presence of uterine tumors, endometrial hyperplasia, cervical lesions, vaginal lesions, etc.
It is advisable to consult a physician for further evaluation if the bleeding persists.
Thank you! Wishing you peace and health.

Dr.
Zhang

Reply Date: 2017/03/10

More Info

Prolonged menstrual bleeding, also known as menorrhagia, can be concerning, especially when accompanied by large blood clots. In your case, experiencing heavy bleeding for seven days with various sizes of blood clots and a bright red color, without accompanying pain, raises several important considerations.

Firstly, it’s essential to understand that menstrual cycles can vary significantly among individuals. Factors such as hormonal imbalances, stress, changes in weight, and underlying medical conditions can all influence the menstrual cycle. However, when the bleeding is heavier than usual or lasts longer than a week, it may indicate an underlying issue that requires medical attention.

Blood clots during menstruation are not uncommon, especially when the flow is heavy. The uterus sheds its lining, and if the flow is rapid, the blood may clot before it exits the body. However, if you notice an increase in the size or frequency of these clots, or if the bleeding continues beyond the typical duration of your period, it is advisable to seek medical evaluation.

Here are some potential causes of prolonged menstrual bleeding and large blood clots:
1. Hormonal Imbalances: Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can lead to irregular and heavy menstrual bleeding.

2. Uterine Fibroids or Polyps: Noncancerous growths in the uterus can cause heavy bleeding and the formation of blood clots.

3. Endometriosis: This condition occurs when tissue similar to the lining of the uterus grows outside the uterus, leading to heavy bleeding and pain.

4. Coagulation Disorders: Some individuals may have blood clotting disorders that can lead to heavier menstrual bleeding.

5. Pelvic Inflammatory Disease (PID): Infections of the reproductive organs can also cause abnormal bleeding.

Given your situation, it is crucial to monitor your symptoms closely. If the heavy bleeding continues, or if you experience any of the following symptoms, you should seek medical attention promptly:
- Soaking through one or more pads or tampons every hour for several consecutive hours.

- Passing large clots (larger than a quarter).

- Symptoms of anemia, such as fatigue, weakness, or shortness of breath.

- Any sudden changes in your menstrual cycle that are not typical for you.

In terms of when to seek help, if the bleeding persists beyond seven days, or if you have concerns about the volume of blood or the size of the clots, it is advisable to consult a healthcare provider. They may perform a physical examination, ultrasound, or blood tests to determine the cause of your symptoms and recommend appropriate treatment options.

In conclusion, while some variation in menstrual bleeding is normal, prolonged heavy bleeding with large clots warrants further investigation. Early intervention can help identify any underlying conditions and prevent potential complications. Always trust your instincts; if something feels off, it’s best to seek medical advice.

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