7 causes of menstruation with clots (and what to do)

Menstruation can flow down in pieces, which are usually in form of blood clots. This situation is perfectly normal and it arises due to hormonal imbalances in the woman’s body. When this hormonal imbalance occurs, the inner walls of the uterus may thicken, causing abundant bleeding and formation of clots which can range from 5mm to 4cm thick.

Although menstruation with clots is normal and in most cases does not require treatment, in other cases in might be as a result of diseases such as anaemia, endometriosis or myoma. For this reason it is important to consult a gynaecologist who will assess the cause of blood clots and afterwards give guidance on the appropriate treatment.

Here are some of the reasons behind when the woman has more than 2 menstrual cycles that come with clots:

1. Abortion

Blood clots during menstruation may be a sign of miscarriage in the first trimester of pregnancy, especially if the colour is slightly yellowish or greyish.

What to do: To confirm if an abortion has occurred, it is very important to visit a gynaecologist who will perform the beta hcg exam.

However, if the bleeding becomes too abundant, one should quickly go to the hospital to start proper treatment so as to prevent loss of much blood. In most cases, abortion usually occurs in the first weeks of pregnancy and the bleeding lasts between 2 to 3 days.

2. Endometriosis

Endometriosis is characterized by the growth of endometrial tissue outside the uterus, which can cause abundant menstruation, severe pain and blood clotting. Although the disease is more frequent in women between 30 and 40 years, it can arise at any age.

What to do: One should consult the gynaecologist who will perform tests such as transvaginal ultrasound or blood tests, so as to confirm the diagnosis. The treatment prescribed usually depends on the woman’s desire to become pregnant, an it can be done with the use of medicines, hormones or surgery.

3. Myoma

Myoma is a benign tumour that occurs in the inner walls of the uterus and it causes symptoms such as pain in the uterus, abundant menstruation accompanied by clots and bleeding outside the menstruation period.

What to do: It is important to consult a gynaecologist who will perform a pelvic ultrasound so as to confirm the presence of myoma. Treatment can be done using medicines, surgery to remove the myoma or embolization of the myoma.

4. Iron deficiency anemia

Iron deficiency, commonly referred to as anaemia can be another cause of menstruation with clots. This is because iron deficiency can alter blood clotting, leading to the appearance clots during menstruation.

What to do: It is advisable to consult with the doctor so that a blood test is done to confirm the presence of anaemia. When the disease is confirmed, anaemia can be treated with an iron supplement, which is prescribed by the doctor. It is also recommended to consume foods rich in iron such as lentils, parsley, beans and meats.

5. Other diseases affecting the endometrium

Other diseases that cause menstruation with clots include endometrial conditions such as hyperplasia, which is excessive endometrial growth, or polyposis, which is the formation of polyps in the endometrium. All these cause growth of the uterus hence menstruation will be in clots.

What to do: Consult the gynaecologist who will identify the correct problem. Treatment can be done with curettage of endometrial tissue or with the use of progesterone hormone.

6. Deficiency of vitamins and minerals

The deficiency of vitamins and minerals that regulate the formation of clots such as vitamin C and vitamin K alters blood clotting hence causing formation of clots during menstruation.

What to do: In such cases, it is important investigate which vitamin or mineral is in the least amount in the body so as to consume foods rich in that vitamin. It is therefore recommended to increase intake of foods such as spinach, orange, strawberry, broccoli and carrots, so as to avoid clots during the menstruation.

7. Gynecological examinations or childbirth

Menstruation with clots can occur after some gynaecologists examinations or when complications take place during childbirth.

What to do: Usually, menstruation stops presenting changes after 2 or 3 days, after which the cycle returns to normal. Therefore if the clots continue to appear, consultation with the gynaecologist should be done.

When menstruation comes with skin

Menstruation can also come with small pieces of skin but that does not always mean the woman had an abortion. The pieces of skin are small pieces of the woman’s own endometrium, but they are usually colourless. The colouration is due to red cells and white cells that are present in the blood.

If the woman experiences menstruation with pieces of skin in 2 cycles in a row, it is recommended to go to the gynaecologist so that they can do an observational examination and do other tests if necessary.