What are Perimenopausal blood clots? Are they something to be weary of?

Menopause is that time for women where in their 40’s or 50’s their period finally comes to an end. It occurs when you haven’t had your period in 12 months and on average, most women experience it at age 51.

Perimenopause however is the transition time before menopause and usually lasts around four years although for some women, it can be five to ten years before their final period. In the perimenopausal stage, there are physical and emotional changes which may occur that can be difficult, painful and sometimes confronting. Dr Elissa Heneike says that “fluctuating hormone levels during perimenopause can cause a range of symptoms including irregular periods, changes to bleeding, hot flushes, insomnia, fatigue, weight gain, vaginal dryness, mood changes, breast tenderness and reduced concentration.”

During perimenopause, your menstrual cycle can become longer or shorter, you may skip a period, or the flow may become lighter or heavier. These changes are a result of your diminishing ovarian function. Majority of systems and organs in our bodies are sensitive to oestrogen meaning that every woman is unique in their menopausal transition.

Dr Heneike says that “bleeding or spotting between periods or with sex, and bleeding if it has been more than 12 months since your last period can be early signs of medical problems and you should see your GP.”

Health experts warn that blood clots are a normal part of the menopausal stages however, heavy and clotty periods can signal an underlying problem. Below is an indication if you should be concerned or if you should just let your period do its thing!

During menstruation, a woman’s lining sheds and their body releases anticoagulants to help break it down. If the blood flow is faster than the body’s ability to produce anticoagulants, blood clots are released. Menstrual clots are a normal part of menstruation and are made up of blood and protein.

Normal vs abnormal blood clots

Menstrual blood clots are often associated with excessive bleeding and unlike blood clots in veins, they generally aren’t dangerous. During a heavier period, it is common to notice small blood clots in the toilet bowl or your underwear. It is particularly common when your period is of a darker colour as it has had time to build up, in comparison to a lighter and quicker flow of blood that would be a brighter red. However, if you notice larger blood clots that are a similar size to a golf ball or consistently around the size of a 5cent coin, it is important to consult your doctor as this indicates excessively heavy and abnormal bleeding. Abnormal bleeding also includes needing to change your pad or tampon more than every two hours, gushing blood and bleeding for longer than a week.

Irregular and heavy bleeding should be taken seriously as it could be a sign of:

• Uterine fibroids: small, non-cancerous growth in the uterus. Additional symptoms include lower back pain, bloating or pain during sex.
• Endometriosis: a condition where the tissue from the uterine lining grows outside the uterus. This can cause abdominal pain, heavy periods and more. Blood clots can be a symptom of endometriosis so is worth noting if you think you may suffer from the condition.
• Adenomyosis: when the uterine lining grows into the muscular wall of the uterus which makes the lining much thicker. This causes a heavier flow and sometimes clots.

Managing the symptoms of perimenopause

Although perimenopause naturally occurs as you get older, there are ways that can help alleviate some of the effects and pain. These include:

1. Maintaining a healthy lifestyle
2. Maintaining a healthy weight
3. Having a nutritious diet
4. Limiting caffeine and alcohol intake

Additionally, there are natural supplements and medication that can help lessen the symptoms of menopause however it is recommended to visit your doctor for advice that is suitable for you.

Medical Disclaimer: Articles are intended for informational purposes only and should not be used as the basis of patient treatment. Ask a medical professional if you have any health-related questions or concerns.

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Additional resources

House of Wellness. (2022). Perimenopause: should you be worried about blood clots during your period?https://www.houseofwellness.com.au/health/news/perimenopause-symptoms