In pre-menopause (perimenopause), your hormones become erratic, causing irregular bleeding and even blood clots. The sight of blood clots in perimenopause may be scary, but most causes of blood clots in perimenopause are benign--and treatable. The important thing is to have the condition causing them diagnosed and treated promptly.
What is Pre-menopause?
Pre-menopause is medically termed as perimenopause. It is the two- to eight-year transition before menopause. The hormone estrogen, which is responsible for the functioning of your ovaries, menstrual cycle and ovulation, starts to gradually decrease in perimenopause, causing your menstrual cycle to become more sporadic. This continues throughout perimenopause, until estrogen drops enough to completely stop menstruation, thus beginning menopause. Menopause usually occurs between the ages of 45 and 55, with perimenopause starting in the late 30s or early 40s.
What are Blood Clots?
Blood clots are a normal occurrence in menstruation and perimenopause. Normally these blood clots, which vary in color (bright red to dark red), are present when bleeding is heavy; they may appear as one or many. Your body normally produces anticoagulants to keep blood from clotting. However, when you bleed heavily, these anticoagulants aren't released fast enough, causing some blood to clot.
How Blood Clots Form
Since there is still enough estrogen circulating throughout your body in perimenopause, your menstrual cycles will remain active. But your level of estrogen will rise and decline spontaneously. This can cause irregular menstrual bleeding, which may be heavy or light and contain blood clots. Fluctuating hormone levels that cause heavy bleeding may slow the body's release of anticoagulants, which will cause clotting.
One common cause of blood clots in perimenopause besides hormonal imbalances is miscarriage. Since you can still get pregnant in perimenopause, you may run the risk of having a miscarriage. When a miscarriage takes place, you may pass blood clots, or gray clumps of tissue. Once the miscarriage is complete, the heavy bleeding and blood clots will stop. Another cause of blood clots is uterine fibroids, benign growths that form in the uterine lining. They can appear as one or many, and may not always cause symptoms. Women with uterine fibroids may experience more bleeding than a normal menstrual flow. Other causes include endometriosis and dysfunctional uterine bleeding (unexplained uterine bleeding).
If your blood clots are caused by a hormonal imbalance, oral contraceptives can balance the hormone levels. For fibroids, treatment may include male hormones (androgens) or a progestin-releasing IUD (intrauterine device), which cancel out the effects of fluctuating estrogen and shrink the fibroids.
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