The perimenopause is the time directly before the menopause, when you still have periods, but the fluctuating and low hormone levels – especially estrogen – can trigger a whole host of symptoms, including heavy periods.
Some women experience high levels of estrogen and low levels of progesterone. This can cause the uterine lining to thicken. When a thick uterine lining sheds during menstruation, women might experience heavier blood flows and larger blood clots.
If a hormone imbalance occurs, the endometrium develops in excess and eventually sheds by way of heavy menstrual bleeding. A number of conditions can cause hormone imbalances, including polycystic ovary syndrome (PCOS), obesity, insulin resistance and thyroid problems.
Menorrhagia can be caused by an imbalance in estrogen and progesterone levels. Some women have elevated estrogen levels and low progesterone levels. This can lead to a thickening of the uterine lining, which often results in heavy bleeding.
Heavy menstrual bleeding can be related to uterus problems, hormones or illnesses. Polyps, fibroids or endometriosis can cause abnormal uterine bleeding. There can be some bleeding in the early stages of pregnancy.
It's crucial that you wear the right pad and let it absorb the gush! 70% of your menstrual flow comes in the first two days of your period, so it's best to use a more absorbent pad like the Modess® All Nights since it absorbs 25% more liquid than the regular pad, and isn't only for bed time use.
Endometriosis blood clots may appear as dark or bright red clumps or blobs in menstrual flow. The clots can vary in size and texture, ranging from small and grainy to larger and more jelly-like in consistency.
Low levels of estrogen result in intermittent spotting that may be prolonged but is usually light in the amount of flow. High levels of estrogen for prolonged periods of time result in lengthy periods of amenorrhea followed by acute, often heavy, bleeding with excessive blood loss.
Tablets that contain the hormone progesterone can be taken for the treatment of heavy periods. Progesterone inhibits the growth of the lining of the womb before menstruation, which lessens the bleeding during menstruation.
Hot flashes, flushes, and night sweats are the most common symptoms of low estrogen. At times, blood rushes to your skin's surface. This can give you a feeling of warmth (hot flash). Your face may look flushed.
You may be surprised by a heavier flow
For some women, midlife brings a temporarily heavier flow. However, if you experience heavy periods on a regular basis or have a period that lasts more than 14 days, see your doctor. “It's normal for menstrual flow to increase for a time.
Polyps and Fibroids
Uterine polyps that grow on the cervix or in the lining of the uterus can also be a factor in heavy clotting. If you're experiencing heavy bleeding, large blood clots during your period or lower back pain, it could be a uterine obstruction like a fibroid.
A normal menstrual cycle lasts anywhere from three to seven days and occurs every 21 to 35 days. Most women on average lost 30 to 50 milliliters of blood during their period. Clinically, heavy bleeding means you lose more than 80 milliliters of blood each cycle or your period lasts longer than seven days.
Vitamin A deficiency has been found in women with heavy periods. One study showed that 92 percent of women prescribed supplemental vitamin A found that their heavy bleeding was either cured or alleviated.
Estrogen drives your period. If you don't have enough, your menstrual cycle could disappear completely. This is normal during perimenopause, and of course, menopause.
Women with too much estrogen may have heavy and painful periods. This can happen to women who still get their period regularly and those who are experiencing irregular periods.
As women transition into perimenopause, (this typically starts after the age of 40), there can be subtle changes in bleeding. Irregular ovulation during perimenopause can lead to heavy irregular periods.
What about HRT? You may find cyclical HRT, which involves taking estrogen every day, and adding in progesterone some of the time, helps regulate your cycle and reduces heavy bleeding. HRT would also ease any other perimenopause symptoms you may be experiencing.
Low estrogen can affect your body in various ways, depending on where you are in terms of your sexual development. Low estrogen: May delay puberty, slow or prevent sexual development. Occurs in perimenopause and menopause, often leading to painful sex, lower sexual desire and hot flashes.
As estrogen levels drastically change in perimenopause, high levels can cause bloating, breast tenderness, and heavy bleeding. Once these levels become more consistently low, that can cause hot flashes, night sweats, mood changes, changes in fat distribution (new or growing “spare tire”), insomnia, and fatigue.
You're not alone. Occasional heavy periods, called menorrhagia, are common in perimenopause. One study of more than 1,300 middle-aged women reported that 91 percent of them experienced at least one occurrence of heavy flow lasting three or more days during a three-year timeframe.
Endo belly is a severely bloated abdomen common in people with endometriosis. Some people say their swelling gets so bad, they look like they're pregnant. “People with endometriosis often have symptoms for years before receiving an accurate diagnosis,” says women's health specialist Megan Billow, DO.
Endometriosis can also cause a person to have spotting. Spotting is when a person bleeds in small amounts between periods. Blood that occurs due to spotting may be red, pink, or brown.
Experiencing small blood clots during your period is usually nothing to worry about but frequently passing clots, heavy bleeding, or larger blood clots can indicate an underlying condition like uterine fibroids or adenomyosis.