Experiencing heavy periods with clots after 40? Here’s why

It is important to change your menstrual product like a pad every 4 hours. But if you are doing it more often then it may be due to heavy menstrual bleeding. It is something that can be experienced by girls or young women. But if you get heavy periods with clots after 40, you may find it alarming. It is usually because of perimenopause, which is the time when you transition to menopause. It may also be due to hormonal imbalance, which often happens during different stages in life. Heavy periods with clots after 40 may also be a sign of a blood clotting disorder.

What are heavy periods?

Heavy periods, medically known as menorrhagia, refer to an increase in the bleeding while you are down. “This could be an increase either in the number of days of bleeding or abnormally heavy or prolonged,” says obstetrician and gynaecologist Dr Nidhi Khera.

If you reach out for a new pad or tampon after less than 2 hours or your periods involve passing huge clots, they are considered heavy, as per the US Centers for Disease Control and Prevention. “On average, during a normal period you lose around 30–40 ml of blood, which is about 2–3 tablespoons. If it is heavy, it will be 80 ml or more per cycle,” says the expert.

Here are a few key signs of heavy periods:

• Soaking through one or more menstrual products like sanitary pads or tampons almost every hour
• Waking up at night to change the period product
• Experiencing vaginal bleeding that continues for more than 7 days
• Passing large blood clots while menstruating
• Needing to restrict your daily activities, especially the ones that involve frequently moving around, due to heavy flow

What are the causes of heavy periods with clots after 40?

Here are some of the causes of heavy periods with clots after 40:

1. Perimenopause

It is the period leading up to menopause, which is the time when menstrual bleeding completely stops. Heavy period is a common symptom in the years before the onset of the menopause, according to a study published in BJOG: An International Journal Of Obstetrics And Gynaecology. “During this time, a woman may have irregular periods with heavier or lighter flow. Sometimes, the uterine lining can build up too much and then shed heavily, often with clots,” says Dr Khera.

2. Uterine fibroids

These are growths in the uterus that are usually non-cancerous in nature. “Uterine fibroids increase the surface area of the uterine lining and tend to interfere with its normal shedding. This can lead to heavier bleeding as well as clot formation,” says the expert.

3. Adenomyosis

It is a condition where the endometrial tissue, the lining of the uterus, grows into the uterus’ muscular wall. The reason why it causes heavy periods with clots after 40 is that it thickens the uterine wall. This makes periods longer, heavier, and more painful, often with large blood clots.

4. Hormonal imbalance

After women turn 40, ovulation becomes irregular, which can lower progesterone levels. Hormonal medications could include estrogen and progesterone combination pills or only progesterone pills. Hormonal imbalance can lead to heavy periods with clots after 40, as estrogen continues to stimulate the uterine lining. But without enough progesterone to regulate it, the lining can become too thick, and result in heavier, clot-filled periods.

5. Endometrial polyps

These are small and soft benign growths on the uterus’ lining. These can cause heavy periods with clots after 40, as the polyps disrupt the normal shedding process. “They may lead to spotting, heavy bleeding, or clots, especially in perimenopausal women,” says the expert.

6. Blood clotting disorder

Conditions like von Willebrand disease, which is a bleeding disorder where the blood does not clot in a proper manner, may be the reason behind heavy periods with clots after 40. As the clotting process is impaired, women with this disorder may experience heavy periods with blood clots.

How to treat heavy periods with clots after 40?

Treating heavy periods with clots after 40 depends on the underlying cause and your overall health. Here’s what you can do:

1. Lifestyle modifications

• Dietary changes: Heavy periods can cause iron-deficiency anaemia, according to a study published in The Lancet Global Health. “Eat iron-rich foods like spinach, lentils and raisins to prevent anemia,” says the expert.
• Supplements: Iron supplements, if anemic, can be taken but only when advised by your gynecologist.
• Exercise: Regularly engaging in physical activity can help reduce estrogen dominance. So, start working out to help balance your hormones.

2. Medical and surgical options

• Uterine fibroid treatment: “Uterine artery embolization, myomectomy or hysteroscopic removal of fibroids may be suggested by your doctor,” says the expert.
• Endometrial ablation: It is a procedure that destroys the uterine lining so that periods can be reduced or stopped completely.
• Medication: In the case of von Willebrand disease, Desmopressin, a medication available as an injection, can help control bleeding.

Heavy periods with clots after 40 may be due to hormonal imbalance, uterine issues like fibroids, or perimenopause. So, you need to understand the underlying cause, and not just pass it off as a regular symptom.