Heavy periods with clots after childbirth

Restoration of the menstrual cycle after childbirth indicates that the woman's body is returning to normal after a long period of bearing, giving birth and breastfeeding a child. However, this recovery process is far from always smooth and predictable. Some women may complain of irregular menstruation, while others are bothered by heavy periods after childbirth. What actually affects the quality and frequency of the menstrual cycle, and what changes occur in the female body after childbirth?

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Epidemiology

According to various data, the incidence of heavy menstruation after childbirth fluctuates between 40-60% of women. The frequency depends on the characteristics of the pregnancy and labor, the presence of concomitant diseases and the age category of the woman.

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Causes heavy periods after childbirth

The bleeding that a woman experiences shortly after childbirth is not considered menstrual. This is lochia - blood discharge with elements of the endometrium, which is a wound discharge from the uterine cavity. Even normally, such discharge can be quite abundant at first: women are often forced to use urological pads instead of regular ones to cope with the problem.

Over the course of several months after childbirth, the female body gradually recovers: the uterus regains its previous volume, the hormonal balance returns to normal, and impaired blood circulation stabilizes.

For those young mothers who did not breastfeed their child, menstruation may resume 2 months after the baby is born. However, this process is very individual and can vary significantly. The first period can be both very heavy and scanty - and this is also individual.

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Risk factors

The risk of the first heavy periods after childbirth is increased in the following cases:

• if there was a complicated birth;
• if a caesarean section was used as a method of delivery;
• if a woman previously had chronic pathologies of the reproductive organs;
• if after childbirth a woman develops inflammation in the genitals;
• if there is a deficiency of vitamins and minerals in the body;
• if a pregnant woman has been diagnosed with low hemoglobin levels;
• if a woman is often subject to stress or is in a depressive state.

A pathological cause of heavy periods in the postpartum period is sometimes hyperplastic changes in the endometrium - this is tissue proliferation that occurs as a result of hormonal imbalance or significant tissue trauma during childbirth.

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Pathogenesis

The normal volume of blood lost during the first period after childbirth is no more than 50 ml during the entire menstrual period. If we talk about heavy menstruation, then this is one in which blood loss is up to 80 ml. If the pad has to be changed more often than once every 2 hours, then there is reason to suspect pathology.

Heavy bleeding, which can be considered a normal variant, can be caused by:

• overstretching of the uterine organ during pregnancy, which caused an increase in the amount of endometrium;
• strong hormonal changes.

It is clear that the exfoliated endometrium must be removed from the uterine cavity, and this happens precisely during menstruation. With the blood come out particles of tissue, which can look like small clots - and this is also considered a normal indicator. However, such heavy periods after childbirth should not be repeated from month to month - over time (after 1-3 months) the cycle usually improves and becomes the same as before pregnancy.

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Symptoms heavy periods after childbirth

The first period after the birth of the baby can really differ significantly from those that a woman is used to observing before the onset of pregnancy. And here, in addition to the actual bloody discharge, other symptoms may be present: for example, the appearance of clots, a change in the color of the discharge, the appearance of an odor, a general state of discomfort, etc.

To begin with, it is important to remember the first signs that you need to urgently go to the doctor:

• frequent change of pads (once every 2-3 hours);
• bleeding lasts more than a week;
• bright scarlet color of discharge;
• significant abdominal pain during menstruation;
• the appearance of a foreign unpleasant odor in the discharge.

With severe blood loss during heavy periods after childbirth, signs of increasing hemoglobin deficiency may also be observed:

• chronic fatigue, sleep disorders;
• frequent dizziness and a feeling of weakness, especially in the morning;
• irascibility, irritability;
• paleness of the skin;
• deterioration of the condition of hair, nails, and skin.

If the first period after childbirth is heavy, then it is necessary to make an appointment with a gynecologist. The same should be done if the breastfeeding stage is over, and the monthly cycle is in no hurry to recover.

Heavy periods with clots after childbirth can be both normal and pathological. It is certainly impossible to determine the cause of such a course of events on your own. Therefore, a visit to the doctor in the postpartum period is usually considered planned: after all, one cannot exclude the possible development of diseases, complications, repeated pregnancy and even premature menopause.

It is generally accepted that the first period after childbirth cannot appear as long as the young mother breastfeeds the baby. However, heavy periods after childbirth during breastfeeding are also possible, and this is due to a change in the balance of the hormone prolactin in the female body. To accurately determine the cause of such a change, it will be necessary to take tests for the state of the hormonal background - it may be necessary to further drug correction of this disorder.

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Complications and consequences

Unfortunately, after childbirth, when it would seem that all the most unpleasant things are already behind us, all sorts of complications and consequences may arise. Such consequences may include serious painful processes: bleeding, infectious and purulent diseases, anemia, etc.

The most severe consequences are considered to be:

• infection - for example, staphylococcal infection. The causes may be acute inflammation during pregnancy, chronic infections in the body, prolonged dehydration;
• endometritis is an inflammatory process in the uterus. The disease can begin to develop after untreated sexually transmitted infections, as well as after a bimanual uterine examination.

Any suspicious symptoms that arise in the postpartum period, including heavy periods, should always be alarming and become a reason for an early visit to the gynecologist. There should be no delay under any circumstances: such complications are too serious.

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Diagnostics heavy periods after childbirth

When visiting a doctor, a woman should tell him about all complaints and signs of heavy periods. Already at this stage of diagnosis, the doctor may suspect one or another pathology, if any.

Some diagnostic procedures will follow:

• examination on a gynecological chair with an assessment of the quantity, consistency and quality of vaginal discharge;
• taking smears for examination (to determine the infection or its reaction to certain medications);
• general blood test, determination of hemoglobin levels and the presence of signs of an inflammatory process in the body;
• blood tests to assess the quality of coagulation;
• determination of hormonal levels in the blood.

Instrumental diagnostics for heavy periods most often includes an ultrasound examination of the pelvic organs. Ultrasound allows you to detect and identify diseases of the uterus, ovaries, tubes, and also monitor their condition. In some cases, it is advisable to replace ultrasound with magnetic resonance imaging.

From practice, the above diagnostic procedures are quite sufficient to identify any pathology in the reproductive sphere that could lead to excessively heavy periods after childbirth.

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Differential diagnosis

Differential diagnostics in this case can be carried out:

• with hormonal disorders;
• with inflammatory processes in the uterus;
• with tumors, both benign and malignant;
• with disorders of the blood coagulation system;
• with endometrial hyperplasia, erosions and endometriosis.

Treatment heavy periods after childbirth

After identifying the true cause of heavy periods after childbirth, the doctor will begin treatment, which is prescribed individually.

If the visit to the doctor was timely, or the cause of this condition is not critical, then the treatment can be carried out on an outpatient basis. In other cases, the patient can be hospitalized.

In most cases, the following medications are prescribed to stabilize the menstrual cycle:

• hemostatic agents (Dicynone, Water pepper extract, Aminocaproic acid);
• antianemic drugs (Fenuls, Ferrum-lek, Sorbifer);
• blood component preparations (plasma, red blood cell mass);
• vitamins as a general tonic and vascular strengthening agent (Ascorutin, ascorbic acid, cyanocobalamin, folic acid, Vikasol).

After the amount of discharge has stabilized, measures to prevent further disturbances of the menstrual cycle may be prescribed. This may be a course of hormonal therapy (oral contraceptives or gestagens), antibiotic therapy, etc. If the doctor has detected an intrauterine pathology, then the corresponding disease is treated.

The most commonly used symptomatic treatment for heavy periods after childbirth is:

	Method of administration and dosage	Side effects	Special instructions
Dicynone	The hemostatic agent is prescribed for heavy periods in a daily dosage of 10-20 mg per kg of weight. The dose is divided into 3 or 4 doses.	Dizziness, headache, nausea, allergies, facial flushing, and decreased blood pressure may occur.	Before starting to take the drug, it is necessary to make sure that the cause of bleeding is physiological.

	Method of administration and dosage	Side effects	Special instructions
Etamsylate	For heavy periods after childbirth, the drug is administered intramuscularly, 1-2 ampoules 3-4 times a day.	Headache, hypotension, abdominal pain, allergies, bronchospasm, back pain, urticaria, dizziness may occur.	During treatment with etamsylate, breastfeeding is temporarily suspended.

	Method of administration and dosage	Side effects	Special instructions
Vikasol	For heavy periods after childbirth, Vikasol is taken 15-30 mg per day, 2-3 times. The duration of administration is determined individually.	Skin rashes, redness of the skin, and bronchospasm may occur.	Vikasol is not used in cases of a tendency to thrombosis.

	Method of administration and dosage	Side effects	Special instructions
Aminocaproic acid	In case of heavy periods after childbirth, the drug is administered intravenously as a drip, with an individually selected dosage.	Dizziness, nausea, tinnitus, difficulty breathing through the nose, decreased blood pressure, and convulsions are observed.	Lactation should be stopped during treatment.

Physiotherapy treatment during heavy periods is not indicated - bloody discharge from the genitals is one of the contraindications to physiotherapy. Warming of organs is prohibited in case of oncology, endometriosis, benign tumors. Only in some cases can magnetic therapy be prescribed - a procedure that relieves inflammation and soothes pain.

Folk remedies

From folk medicine, you can borrow a large number of recipes to reduce the abundance of discharge and stabilize the monthly cycle. However, they can only be used after visiting a gynecologist.

• In case of heavy discharge, take 1 tbsp. of viburnum berries and pour 200 ml of boiling water over them, boil for half an hour. Then drink the decoction 1 tbsp. three times a day before meals.
• It is useful to drink viburnum juice, sweetened with sugar or honey, in quantities of at least 3 tablespoons 4 times a day.
• Heavy periods can be brought back to normal by preparing the following remedy: boil the peel of seven oranges in 1 ½ liters of boiling water until no more than half a liter of broth remains, which is filtered and sweetened with honey. Drink 200-300 ml of the broth 30 minutes before meals three times a day.

In addition to folk remedies, in case of heavy periods after childbirth, you can also use recipes for medicines based on medicinal herbs.

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Herbal treatment

• Pour 1 tbsp of strawberry leaves into 0.5 l of boiled, settled water overnight. In the morning, strain the medicine and drink 100 ml daily.
• Brew 1 tbsp. of horsetail in 250 ml of boiling water. Take the infusion 1 tbsp. every 2-3 hours.
• Prepare a mixture based on equal parts of wormwood, knotweed, shepherd's purse, clover, nettle, as well as licorice rhizome and viburnum bark. It is also useful to add rose hips to the resulting mixture. Pour 2 tbsp of the mixture with one liter of boiling water and leave in a thermos for 5-6 hours. You need to drink all of the resulting medicine throughout the day.
• Place 3 tablespoons of parsley in a thermos, pour in 0.5 liters of boiling water, and leave for 5-6 hours. Take 100 ml of the infusion 30 minutes before meals: in the morning, before lunch, before dinner, and at night.

Homeopathy

Heavy periods after childbirth - this problem is often solved by homeopathy - a special science that involves the use of certain drugs with a minimum risk of side effects and the maximum possible benefit for the body. With heavy periods, the main task of homeopathic remedies is to regulate hormonal levels and stabilize the duration and quality of the menstrual cycle.

What medications are most effective for heavy periods after childbirth?

• Cyclodinone - for heavy periods, take 40 drops in the morning, with water, before breakfast. The course of treatment lasts at least 3 months, without breaks during menstrual bleeding. Very rarely, the drug can cause allergies.
• Ovariamin - for heavy periods after childbirth, take 2 tablets twice a day for a month. It is recommended to stop breastfeeding during treatment.
• Ovarium compositum - for heavy periods after childbirth, injections of the drug are prescribed, 1 ampoule once every three days, intramuscularly. The duration of treatment may vary, depending on the indications.
• Remens - for heavy periods after childbirth, 10 drops are prescribed three times a day for 3 months. Rarely, an allergy to the drug may develop.

Surgical treatment

In case of heavy menstruation after childbirth, surgery is prescribed only in cases where it is necessary to remove a tumor process or endometrial hyperplasia. In this case, a histological analysis of the removed tissues is performed.

An operation to completely remove the uterine organ - hysterectomy - in women with heavy periods is performed only in very serious situations, when the issue of preserving the reproductive function becomes secondary. This happens rarely: in the vast majority of cases, the problem is solved by conservative medication.

Prevention

The appearance of irregular and pathological first periods after childbirth can be prevented if you follow certain recommendations immediately after discharge from the maternity hospital.

• It is important to eat well and drink enough fluids.
• If possible, stress and anxiety should be avoided.
• It is necessary to treat any diseases in a timely manner, and also undergo all examinations recommended by the doctor.
• It is necessary to discuss with relatives the possibility of a full rest for the young mother, as well as to ensure that she gets quality sleep.
• Blood counts should be monitored periodically to detect anemia in a timely manner.

Two weeks after giving birth, and thereafter, it is necessary to visit a gynecologist for preventive examinations - this is a very important and necessary procedure that allows you to maintain the health of the young mother for a long time.

Forecast

If a woman notices that she has heavy periods after giving birth, she should not panic: perhaps this is one of the physiological norms. However, this condition should not be completely ignored either: a specialist consultation should be mandatory. Firstly, if there is no pathology in the body, this will allow the woman to calm down and not worry in vain. Secondly, if there is a violation, then a timely visit to a medical specialist will allow the problem to be solved faster and better, which will significantly and positively affect the further prognosis.