Endometriosis Blood Clot: What It Is, What It Looks Like, Treatment 

Key takeaways:

• Endometriosis is a medical condition that can cause menstrual abnormalities in females, including the passage of frequent large blood clots. 
• Several factors, such as heavy or prolonged blood flow, can disrupt normal menstrual patterns and cause blood clots. 
• Other conditions, such as abnormal growths in the uterus, infections, and bleeding disorders, can cause menstrual clots. Hence, it is important to see your healthcare provider for proper evaluation. 

Endometriosis is a medical condition in which tissue similar to the inner lining of the uterus (endometrium) grows outside the uterus. This results in pain, inflammation, and menstrual irregularities.

About 10–15% of people with uterus who are of reproductive age have endometriosis and may experience abnormal menstrual symptoms, like atypical blood clots. These clots may be larger and more frequent than typical menstrual clots, particularly those experiencing heavy or prolonged menstrual bleeding. 

Is blood clots during menstruation common in people with endometriosis?

Blood clots during menstruation may be more common in females with endometriosis than in others. This is because endometriosis can cause heavier and more prolonged menstrual bleeding.

This is especially true in adenomyosis, a form of endometriosis in which endometrial tissue grows into the uterine muscle. With this condition, menstrual bleeding becomes heavier and longer, increasing the likelihood of blood clot formation. 

What do endometriosis blood clots look like?

Blood clots associated with endometriosis do not have a typical appearance. They may appear as bright red or dark, thick or lumpy blood clumps, ranging in size from specks to larger masses. 

Additionally, they can feel more gelatinous or dense compared to the smoother, thinner flow of typical menstrual blood.

What causes blood clots in people with endometriosis?

The exact cause of blood clots in people with endometriosis isn’t fully understood, but some factors have been associated with it, such as: 

1. Increased menstrual flow

In adenomyosis, the abnormal growth of endometrial tissue into the muscle affects its ability to contract and constrict blood vessels to stop bleeding effectively. It also causes additional changes in the structure and function of the endometrium.

These factors combined may be responsible for the increased menstrual flow experienced in adenomyosis, which can also increase the likelihood of clot formation. 

2. Inflammation

Endometriosis is a chronic inflammatory condition, and this persistent inflammation can disrupt the delicate balance of the body’s coagulation system.

Research has shown that people with endometriosis exhibit characteristics of an impaired coagulation system. For example, a crucial protein in the blood coagulation cascade, fibrinogen, may be elevated, resulting in a hypercoagulable state (an increased tendency to develop blood clots).

These elevated coagulation factors may promote the formation of menstrual blood clots in endometriosis. 

3. Hormonal imbalance

Hormones play a significant role in maintaining hemostasis (the process that prevents and stops bleeding). Endometriosis is often associated with hormone imbalance, which can disrupt the hemostatic process.

Research has shown that people with hormonal imbalances, such as those seen in endometriosis, may have abnormal coagulation laboratory results. Such abnormalities may contribute to the increased chances of getting menstrual clots in endometriosis.  

4. Formation of scar tissue

Endometriosis can cause scar tissue (adhesions) in the pelvic cavity due to trapped endometriotic tissues outside the uterus. This may affect the contraction of the uterus during menstruation, disrupt normal menstrual flow, and contribute to the formation of clots. 

If blood clots during menstruation are a concern, particularly if they are large or associated with significant pain, it’s best to consult a healthcare provider for evaluation and appropriate management. 

Other endometriosis symptoms

People with endometriosis may experience the following symptoms in addition to the formation of blood clots: 

• Pelvic pain 
• Severe menstrual cramps (dysmenorrhea) 
• Heavy bleeding (menorrhagia) 
• Prolonged menstruation 
• Pain during urination or defecation  
• Pain during sex (dyspareunia)  
• Infertility  

Risk factors for menstrual blood clots

Factors that can predispose one to abnormal menstrual blood clots include: 

• Familial tendency 
• Presence of fibroids  
• Adenomyosis  
• Hormonal imbalance  
• Having bleeding disorders (coagulopathy) 
• Medications like blood thinners and hormonal drugs 
• Thyroid disorders which may lead to hormonal changes  
• Obesity

Other conditions that can cause heavy bleeding or menstrual clots

Aside from endometriosis, other conditions that can cause heavy bleeding or menstrual blood clots include: 

Hormonal imbalances

The reproductive hormones estrogen and progesterone are female hormones responsible for regulating the menstrual cycle. When hormone levels are unstable, the cycle is disrupted, resulting in heavy menstruation and, ultimately, clot formation. Some conditions that can also lead to hormone imbalance include thyroid disorders and polycystic ovarian syndrome (PCOS). 

Non-cancerous (benign) growths in the uterus

Benign growths in the uterus, such as fibroids and adenomyosis, may affect the menstrual pattern. These conditions are often associated with intense menstrual bleeding. 

Cancerous growths

Cancers such as uterine or cervical cancers can alter the cells of the uterus and may also influence the hormones, resulting in abnormal menstrual patterns. 

Infections

Sexually transmitted infections such as gonorrhea, Chlamydia, or trichomoniasis may cause heavier menstrual bleeding, clots, and other menstrual abnormalities.

Poorly managed STIs can progress to pelvic inflammatory disease (PID), a serious complication that not only affects the menstrual cycle but can also lead to infertility. 

Coagulopathy

Bleeding disorders such as Von Willebrand’s disease may result in excessive bleeding during menstruation due to a lack of appropriate or sufficient clotting factors. 

Treatment for endometriosis and menstrual blood clots

There is currently no cure for endometriosis. However, after a detailed examination and confirmed diagnosis of endometriosis, your doctor may manage your condition in any of the following ways.  

Medication:

Painkillers, including nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, may help in managing the cramps. Also, birth control pills, hormone patches, or other hormonal treatments can help reduce the growth of endometrial tissue and decrease bleeding. 

Surgical treatment:

A minimally invasive surgery such as laparoscopy may help remove or destroy the endometrial lesions that have grown outside the uterus. This can help reduce pain and manage symptoms. Also, hysterectomy (surgical removal of the uterus) with removal of both ovaries may help in the definitive management of the condition.

Lifestyle and dietary changes:

A balanced diet, particularly one rich in anti-inflammatory nutrients, helps manage symptoms. Regular physical activity may also alleviate some symptoms. 

When to seek medical attention

Suppose you’re experiencing any of the symptoms mentioned earlier, including unusually large or painful menstrual clots. In that case, it is important to consult a healthcare provider, particularly a gynecologist, for a proper diagnosis and personalized treatment plan.