Heavy Periods After 40 With Clots: Causes, Symptoms, And Management
May 21, 2025 • 7 min read
Published on May 21, 2025 | Update on May 16, 2025
May 21, 2025
Welltech Editorial Team
Table of Contents
Perimenopause is when your body starts its journey towards menopause – which marks the end of your reproductive years. This phase begins around the end of your 30s or in your early 40s. During this time, your ovaries may produce lower levels of reproductive hormones, like estrogen, causing your menstrual cycle to become irregular with heavy or clotty periods.
So, are heavy periods after 40 with clots normal or a matter of concern and is heavy bleeding a sign of menopause? Let’s discuss the signs and causes of perimenopause and menopause heavy bleeding in detail and when to consult your doctor.
Estrogen is a reproductive hormone that is necessary for regulating your menstrual cycle and maintaining sexual health. It helps with the development of secondary sex characteristics, like hips and breasts, thickens the uterine lining for a possible pregnancy, and regulates menstrual cycles.
However, as you reach perimenopause or menopause after your 40s, the estrogen levels naturally begin to fluctuate and decline.
Estrogen stimulates the thickening of the uterine lining, while progesterone helps regulate this growth and prevent excessive buildup. Fluctuations in estrogen and progesterone during your 40s can lead to irregular shedding of the uterine lining, sometimes resulting in heavy or prolonged periods. In some cases, excessive thickening of the lining (endometrial hyperplasia) can occur, which may require medical evaluation.
The common signs that heavy periods are linked to perimenopause may include:
The common causes of heavy bleeding during menopause or perimenopause heavy periods flooding in your 40s and 50s include:
The foremost cause of heavy periods after 40 with clots is the fluctuations or decline in estrogen and progesterone. The hormonal imbalance causes the uterine lining to thicken excessively, leading to heavy bleeding with clots.
Another potential cause of heavy periods after 40 with clots can be an underlying health condition, like thyroid disorders or fibroids. Uterine fibroids and polyps are a condition that causes non-cancerous growths in the uterus which can cause heavy bleeding. Similarly, issues with thyroid function can disrupt hormonal balance and lead to heavy bleeding.
Certain medications, like warfarin, aspirin, tamoxifen, birth control pills, or hormonal replacement therapy can also cause heavy bleeding as a side effect.
Although pregnancy after 40 is rare, it is still possible. Complications in pregnancy, like miscarriage or ectopic pregnancy can also cause heavy bleeding with clots.
Heavy periods at 50 and 40 are a cause for concern if:
So, how to stop heavy bleeding during menopause naturally? Here are some common and natural ways to reduce or manage heavy bleeding during perimenopause or menopause:
Eating foods high in iron and vitamin C, like citrus fruits, red meat, leafy greens, and beans can help reduce your symptoms and fight anemia, which is caused by heavy bleeding. You can also add iron supplements to your daily routine after consulting your healthcare provider.
Perimenopause may cause mood swings and stress can aggravate hormonal imbalance. Hence, to support hormonal production and balance, manage your stress. You can do this through various stress management techniques, like regular exercise, meditation, and deep breathing.
Another natural way to manage heavy bleeding during perimenopause is using herbal remedies. Some common herbs possessing anti-inflammatory properties, that are rich in iron, and that are known to help with heavy menstrual bleeding, include ginger, cinnamon, turmeric, red raspberry leaf, nettle, and yarrow.
” Some dietary and lifestyle modifications, such as increasing iron and vitamin C intake and managing stress, may help alleviate symptoms. However, there is limited scientific evidence supporting the effectiveness of herbal remedies like ginger, turmeric, or raspberry leaf in significantly reducing heavy bleeding. It is best to consult a healthcare provider before using any supplements or herbal treatments. “
Nataliia Yermolovych
MD, Obstetrician-Gynecologist
The common medical treatments for heavy periods after 40 include:
Medications, like iron supplements and non-steroidal anti-inflammatory drugs, like aspirin and ibuprofen can help reduce bleeding, manage anemia symptoms, and ease cramps.
Birth control pills can lighten blood flow. They can reduce bleeding or even stop periods.
Another treatment option that is more effective than birth control pills is hormone therapy or the insertion of a hormonal intrauterine device (IUD) in the uterus. IUDs continuously release progesterone in the body and help control the loss of menstrual blood.
If bleeding is severely heavy and difficult to manage and other treatments become ineffective, surgical removal of the entire uterus may be considered. This procedure is known as a hysterectomy.
You should seek medical help if:
Important to note: Irregular or heavy periods at the end of your 30s or after 40 are normal and commonly a perimenopause symptom, but you should still get a reproductive health checkup done by a gynecologist to rule out other underlying health conditions and avoid any further complications.
Perimenopausal bleeding can indicate that menopause is approaching, but this phase may last anywhere from 4 to 8 years before menopause occurs. A key sign that menopause is near is an increase in the time between menstrual cycles before they eventually stop
Passing occasional small blood clots during perimenopause may not be a cause for concern. However, if you frequently pass clots larger than a quarter (about 1 inch or 2.5 cm) or experience excessive bleeding, consult your healthcare provider to rule out underlying conditions like fibroids, endometrial hyperplasia, or coagulation disorders.
Periods commonly don’t stop suddenly when menopause begins. They gradually become irregular and after getting off-schedule, they simply peter out. Not having your periods for 12 months consecutively means that your menopause has arrived.
Heavy periods after 40 with clots commonly occur due to the decline in estrogen and progesterone hormones that play a role in uterine thickening. Fluctuations or imbalance in fertility hormones can cause excessive uterine thickening, leading to heavy bleeding with clots.
To support overall menstrual health, incorporate iron-rich foods like leafy greens, beans, and red meat to help prevent anemia. Additionally, adequate intake of vitamin C, vitamin K, and magnesium may support blood clotting and reduce excessive bleeding. However, these dietary changes should complement, not replace, medical treatment if needed. You can also take measures to reduce stress. You can do this through stress management techniques, including regular exercise, meditation, and deep breathing.
However, you should consult your healthcare provider for medical treatments if excessive bleeding interferes with your daily life or causes symptoms, like severe cramping, dizziness, or unusual tiredness. Moreover, if you experience blood clots that are larger than a quarter and appear more than twice, it is best to consult your healthcare provider to rule out any underlying conditions.
Medical treatments for managing excessive bleeding can include medications, hormonal therapy, or surgery.
This article is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional advice or help and should not be relied on to make decisions of any kind. Any action you take upon the information presented in this article is strictly at your own risk and responsibility!
