During menstrual bleeding, many women experience small- to medium-sized blood clots. These are completely normal and are not cause for alarm. However, when a woman is going through or has finished with menopause, blood clots can be a symptom of serious changes and are reason to seek the services of an experienced gynecologist. Clotting is the body's way of controlling bleeding and menstrual blood clots occur most often when a woman uses a tampon or other method to block the blood from immediately reaching the outside of the body.
Normal Blood Clots
Most women experience some clotting as part of their regular normal menstrual cycle. According to Dr. Robert Albee, this is not cause for alarm and can occur if some method of blocking the blood from exiting the body has occurred. Generally, the brighter red the blood is when it exits the body, the more immediate the bleeding is--bright red means that the blood is shedding right now and darker, blacker means that the blood congealed into a clot before it exited the body.
According to Albee, although menopause is frequently referred to as a process that a woman goes through, the correct terminology is that a woman goes through perimenopause before she enters menopause. In other words, a woman arrives at menopause when she completely stops having periods, but she goes through perimenopause between having regular periods and stopping entirely. Clots that form during perimenopause are very common and are usually similar to those formed during a normal menstrual cycle.
One of the concerns that can be raised during perimenopausal years is changes to the uterus. One of the symptoms of uterine changes can be an increase in the amount or length of time during which blood clots occur. Albee indicates that uterine changes can include the development of fibroids, polyps or enlargement of the uterus. Fibroids are benign growths inside the uterus and are very common. Polyps are growths inside the uterus and can be obstructive and cause pooling inside the uterus resulting in a clot. Enlargement of the uterus can occur with multiple pregnancies and result in increased pooling of blood inside the uterus.
According to Albee, about 30 per cent to 40 per cent of women who have endometriosis experience abnormal bleeding and the development of abnormal clots. This may be the result of the endometrial tissue developing into a blockage within the Fallopian tubes, which then leads to abnormal bleeding. Although this is not life threatening, it can be an annoyance for many women and the clots often occur between periods.
Hormone Replacement Therapy
Hormone replacement therapy (HRT) is very common for short-term relief of perimenopausal symptoms. According to the Merck Manuals Online Medical Library, women undergoing HRT can experience uterine blood clots as a result of the changes in their hormone balances. Often it is necessary to adjust the dosage of HRT medications in order to avoid uterine clots. One of the risks associated with HRT is the potential development of pulmonary blood clots and blood clots in the eyes.