ZocdocAnswersWhat causes extremely heavy menstruation and severe clotting?

Question

What causes extremely heavy menstruation and severe clotting?

I have to use 8 pads a day and clots range in size some as small as a pea up to a quarter

Answer

Heavy menstrual bleeding is defined as bleeding > 80 ml per day or menses that last longer than 7 days, and is called menorrhagia. I strongly recommend that you see your doctor about this issue. Menorrhagia is very common (10-35% of women have it) and can be caused by a variety of different things. One common cause is anovulation (meaning that no egg has been produced), which would usually be accompanied by irregular periods and absence of the associated symptoms (breast tenderness, abdominal cramping or bloating). Structural problems with the uterus can cause heavy bleeding and include leiomyomas (fibroids), endometrial polyps, or adenomyosis. Certain cancers can cause abnormal menstrual bleeding, most typically endometrial cancer; more rarely cervical cancer or leiomyosarcoma. You can also have abnormal bleeding from an undiagnosed clotting disorder. Heavy menstrual bleeding may be to the only symptom, but could also be accompanied by symptoms of easy bleeding, nosebleeds, and bruising. The likelihood of these different conditions varies quite a bit by age, whether you have any other associated symptoms, and whether your blood level is low enough to make you anemic, so I would strongly recommend that you go see your doctor who can get a better history from you and determine whether any further work-up is necessary.

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