PCOS blood clots: What are these, why do they appear, and how to manage it?

In a nutshell

PCOS blood clots are differently-sized, jelly-like clots consisting of blood cells, proteins, and uterus lining tissue. In most cases, such clots are formed naturally to prevent too much blood from escaping during periods and shouldn’t be a cause of concern. However, in conditions like PCOS, period clotting might become more prominent due to hormonal imbalances and cycle irregularities.

In case you’re concerned about PCOS clots, the baseline management tips include:

• Medications intake to treat PCOS symptoms
• Lifestyle adjustments
• Continuous symptom monitoring

Polycystic ovary syndrome (PCOS) is a female reproductive health condition that causes a range of symptoms, such as cycle irregularity, prolonged periods, etc. Due to hormonal imbalances that it creates, PCOS can also create additional physical symptoms that might feel alarming, such as PCOS blood clots.

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What are PCOS period clots?

Menstrual clots consist of blood cells, proteins, and tissue from the uterus lining that breaks if pregnancy has not occurred in a cycle. Typically, these are a normal occurrence, especially during the first couple of days in your period when the blood flow is typically the heaviest. These small to medium clots are your body's natural defense mechanism. They appear during the heaviest days of menstruation to prevent too much blood from escaping, similar to clotting that can be found in a cut.

Although often menstrual blood clots shouldn't be a cause of concern. Some health conditions, such as PCOS or endometriosis, can cause the clotting defense mechanism to work more intensely.

PCOS blood clots are often larger and more prominent. This is because this syndrome can cause heavy, fast-flowing periods, whereas your body can’t keep up with the fast pace of bleeding and produce sufficient anticoagulants to keep blood from clotting.

Common causes of PCOS heavy bleeding and clotting

PCOS can cause heavier bleeding with large clots passing in the process for a number of reasons:

• Hormonal imbalances. The imbalance of female hormones and androgens (male hormones) in PCOS women often results in menstrual irregularity and ovulation issues. In cycles when ovulation does not occur, the ovaries don’t produce progesterone, which results in a thicker lining of the uterus, which can cause heavy and prolonged bleeding with blood clots when it sheds.
• Birth control pills. Hormonal contraception is one of the most common treatment methods for PCOS that’s used to regulate hormones and ease the syndrome symptoms. Though the benefits from this treatment are usually more tangible, sometimes, contraceptives can contribute to heavier-than-normal periods with large clots, especially when you’ve just started treatment or changed to a different form of birth control. 
• Insulin resistance. Insulin resistance has a very high (35-80%) prevalence in women with PCOS. Without proper management, insulin resistance can cause chronic inflammation, worsen menstrual irregularity, and cause endothelial dysfunction. In the long run, it can also increase the risk of menstrual clotting.

Additional risk factors for clotting

Apart from the general contributing factors like hormonal imbalance, birth control, and insulin resistance, there are also two extra causes for PCOS heavy periods large clots:

• Obesity. Studies find that obesity and excess weight are 80% prevalent in PCOS females. Similarly to insulin resistance, obesity is also associated with chronic inflammation, which can cause heavier bleeding and clots passing.
• Sedentary lifestyle. A lack of daily activity is often linked to the development of multiple issues, including menstrual disorders. Too much sitting causes a lack of proper blood circulation in the entire body, which can enhance the risk of clotting during menstruation.

Common symptoms accompanying PCOS or endometriosis blood clots

As you already know, PCOS endometriosis blood clots aren’t rare. Clotting often occurs due to hormonal imbalances, specific treatments, and other underlying health problems that come along with these conditions. And often, clotting in these conditions is accompanied by several additional symptoms, such as:

• Irregular menstruation
• A heavy flow of blood that requires frequent pad changes (every 1-2 hours)
• Abdominal cramps
• Back pain
• Clots size of a quarter or larger
• Low energy levels

When your PCOS period clots are cause for concern?

Generally, small to medium-sized period clots shouldn’t be too disturbing. The common symptoms mentioned above might also be normal. However, it’s important to monitor your period’s flow and other symptoms to be able to recognize warning signs.

In particular, your period clots might be a cause of concern if you notice any extreme symptoms. This can include an extremely heavy flow, severe pain, or too huge clots. If you notice any of these and feel concerned, it might be a good idea to see a doctor because any extreme symptoms might signal additional problems, such as endometriosis, fibroids, etc.

Tips to prevent and manage PCOS period clots

Although PCOS heavy bleeding and clotting are rather common and often shouldn’t cause concern, of course, symptoms like these can feel somewhat discomforting and distressing. Luckily, there are a few ways to prevent or manage these symptoms:

Medical treatment

Typically, medical interventions in PCOS target hormonal imbalances and other underlying health complications that might result from PCOS.

For hormonal regulation, healthcare providers typically prescribe birth control pills. Starting taking them can ease a range of PCOS symptoms and eventually help balance your menstrual cycle, thus, helping prevent blood clots as well. In case you are already taking birth control pills and are concerned about your period clots, consider consulting with your doctor and, maybe, switching the contraception type.

As for other medications, you might be suggested to take medicines like metformin and Inositol. These help treat insulin resistance and type 2 diabetes, which also could be contributing factors to period clotting.

Lifestyle changes

Certain lifestyle adjustments can help you target a number of PCOS-related symptoms. Namely, sticking to a healthy diet and exercising regularly can help you naturally restore your hormones and maintain a healthy weight.

Also, incorporating the right PCOS supplements into your daily life can help ease symptoms and regulate your cycle.

Eventually, by helping you stabilize your hormones and cycle, lifestyle changes can help you prevent or manage period clotting as well.

Continuous monitoring

Although PCOS period clots might be a natural part of your body’s protective mechanisms, sometimes, they might be associated with additional risks. As you already know, large clots accompanied by severe blood flow or pain might signal more serious health conditions like endometriosis, fibroids, or even cancer.

In order to prevent risks, it’s crucial to regularly monitor your symptoms. Keep an eye on your cycle regularity, bleeding severity, and other symptoms to be able to notice any alarming signs early on. Also, don’t forget about the importance of regular check-ups to receive personalized treatment for your condition.

Conclusion

PCOS blood clots are a natural mechanism that your body uses to prevent too much blood from escaping during your periods, especially the first few days when the blood flow is heavier. Such clots often can be found in healthy women, though conditions like PCOS can make it more prevalent.

Women with PCOS might be experiencing period clotting more frequently or notice larger clots for a number of reasons:

• Hormonal imbalances
• Birth control pills
• Insulin resistance
• Obesity and an inactive lifestyle

In most cases, clots shouldn’t be a cause of concern even if you have PCOS. However, it’s important to receive proper treatment, adjust your lifestyle, and consistently monitor your symptoms to prevent clotting or be able to notice when it might signal a more serious problem.