Women's Health Community

Dear hippiedippie: The menstrual pattern you have described (erratic, super heavy, and off/on) can be associated with frequent missed ovulations. There can be many reasons for missed ovulations: low thyroid problems, pituitary problems, ovarian cysts, physical stressors (eg sudden increases in exercise, crash dieting), emotional stressors (problems with partners or money), increased body weight, anorexia, rotating shifts at work, etc.

That you are having very large clots is usually an indication of an extremely heavy flow. There is an enzyme produced by the lining of the uterus designed to keep menstrual blood from clotting. This allows the menstrual fluid to more readily pass out of the tiny cervical canal and into the vagina. When a woman is bleeding very heavily during her period the amount of flow surpasses the amount of enzyme--thus leading to passage of large clots.

The severe cramping can be either from the uterus contracting to "squeeze out" large clots through the thin cervical canal or from excessive prostaglandins produced by a very thick uterine lining which is now shedding.

Other cause of super large clots can include: an infection of the lining of the uterus, a missed miscarriage, being recently postpartum or post-abortion, or having a heavy flow due to fibroids of the uterus. Generally we say that clots larger than quarter size mean that the flow is heavy enough to need an evaluation.

You are right in worrying about this current flow. Please get seen by a GYN or even your local county family planning clinic. The source of the heavy flow needs to be assessed. You may have some anemia as well; that could be responsible for the fatigue.

Yours,
Jane