Why do I experience large clots a week before my period?

Hello,

Welcome to icliniq.com.

I can understand how distressing and exhausting this situation must feel, especially when you are dealing with heavy bleeding and large clots.

Based on your description, you are having abnormal uterine bleeding, particularly because of the timing and the presence of large clots. Common causes can include hormonal imbalance (especially progesterone deficiency), uterine fibroids, adenomyosis, endometrial polyps, or sometimes thyroid problems.

In women closer to their late 30s or 40s, changes in ovulation patterns can also cause bleeding to start earlier and become heavier. Passing clots usually means the bleeding is heavy enough that the blood does not have time to clot normally inside the uterus.

It is important to pay attention to warning signs such as dizziness, extreme fatigue, shortness of breath, paleness, or heart palpitations, as heavy bleeding over time can lead to iron deficiency anemia. If at any point you are soaking a pad every one to two hours, feeling faint, or the clots are very large (larger than a coin), that becomes urgent and needs prompt medical attention.

The next best step would be to see a gynecologist for proper evaluation. This usually includes a pelvic ultrasound, blood tests (including hemoglobin, iron levels, and thyroid function), and sometimes a hormonal assessment. Treatment depends on the cause and may range from hormonal medications, non-hormonal options to reduce bleeding, iron supplementation, or specific treatment for fibroids or polyps if present. Avoid self-medicating with hormones unless prescribed, as this can sometimes worsen bleeding patterns.

In the meantime, make sure you are well hydrated, eat iron-rich foods (like leafy greens, beans, lentils, eggs, and meat if you take it), and note down when the bleeding starts, how heavy it is, and how long it lasts. This information is very helpful in diagnosis.

For treatment, you can take Tranexamic acid 500 milligrams twice daily for three days.Tranexamic acid helps reduce heavy bleeding by stabilizing blood clots. During heavy menstrual or abnormal uterine bleeding, clots inside the uterus break down too quickly, leading to excessive flow and clots. Tranexamic acid works by blocking fibrinolysis, meaning it prevents premature breakdown of clots, so bleeding becomes lighter and more controlled. It does not affect hormones, and it does not stop periods. It only reduces the amount of bleeding.

Take one 500 milligram capsule twice daily, preferably after food, for three days only. It usually starts when bleeding is heavy. Do not exceed the prescribed dose.

Most patients notice a reduction in bleeding within 24 to 48 hours. Clots usually become smaller, and the need to change pads decreases. It does not affect future cycles when used short-term. Common side effects are nausea, stomach discomfort, headache, or mild dizziness. These often improve when taken after meals.

Tranexamic acid should be avoided or used with caution in the following conditions: patients with a current or past history of thromboembolic disease, including deep vein thrombosis, pulmonary embolism, cerebrovascular accident, or myocardial infarction, because the drug promotes clot stability and may increase the risk of thrombosis, any kidney disease, or if there is a history of seizures.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.