What are fibroid blood clots
Fibroid blood clots are a common issue for women with uterine fibroids, especially during heavy periods. Uterine fibroids, or leiomyomata, are non-cancerous growths that develop in the uterus, affecting many women, particularly those in their reproductive years [1]. One of the most common symptoms of fibroids is heavy menstrual bleeding, or menorrhagia, which can lead to the formation of blood clots [2, 3].
The clots form because of the irregular blood vessels within the fibroids. These abnormal blood vessels struggle to provide the fibroids enough oxygen and nutrients, causing heavy bleeding and clotting [1]. On top of that, the pressure from enlarged fibroids on the uterine walls can also increase bleeding, making clot formation more likely [3].
Fibroids can also lead to obstructions that affect the uterus’s ability to contract properly. When the uterus can’t contract as it should, blood can pool inside the uterine cavity, which may then coagulate and form clots that are eventually expelled [3]. Additionally, fibroids can cause breakthrough bleeding or bleeding between periods, which can contribute to the formation of clots as well [2].
What do fibroid blood clots look like?
Fibroid blood clots can look different depending on factors like the size and location of the fibroid, as well as the person’s overall health. When fibroids cause heavy menstrual bleeding, known as menorrhagia, it's common to pass larger clots than usual. These clots can sometimes be as big as a quarter or even larger.
Treating Uterine fibroids
Several options are available for treating fibroids, especially those causing significant bleeding.
Uterine artery embolisation (UAE): Uterine artery embolisation (UAE) is a very effective way of treating fibroids. It works by cutting off the blood supply to the fibroids, which causes them to shrink as they essentially "die off" due to a lack of oxygen and nutrients [5, 6]. This treatment is particularly helpful for managing heavy menstrual bleeding, also known as menorrhagia, and is often a good option for patients who have other health issues that make other treatments less viable [7].
UAE can also be a good option for patients who haven’t found relief with other treatments or those who may not be suitable candidates for surgical options [8]. The procedure has a high success rate, with one study showing an 87% success rate and an average 57% reduction in fibroid size [8].
Medications: Another option for managing fibroids is using medication, like gonadotropin-releasing hormone analogues and selective progesterone receptor modulators. These drugs shrink fibroids and help manage uterine fibroid symptoms like heavy bleeding [9]. However, they are usually prescribed for short-term relief, as they do not offer a long-term solution to fibroid-related issues [7].
Other Surgical options: Surgery may be necessary for those seeking more permanent solutions. Myomectomy is one such procedure, in this surgery, the fibroids are removed, but the uterus is left intact, preserving fertility for those who want to have children in the future [9].
On the other hand, hysterectomy involves removing the entire uterus and is a definitive treatment for fibroids, offering relief from symptoms once and for all [9].
In conclusion, the treatment of fibroids must be individualised based on the presence and severity of symptoms and the patient's desire for definitive treatment or fertility preservation [7].
Prevention of fibroid clots
Preventing fibroid-related blood clots involves a mix of lifestyle changes and, in some cases, medical treatments.
Healthy lifestyle: Maintaining a healthy weight is one of the most effective ways to reduce the risk. Regular physical activity and a balanced diet that includes plenty of fruits and vegetables can help you stay on track with this goal [10].
Other helpful measures include managing stress, avoiding smoking, and reducing caffeine and alcohol. These changes benefit your overall health and reduce the chances of fibroid-related complications, including clot formation [11].
Managing Blood pressure: Another important aspect is managing blood pressure. Regular check-ups, monitoring blood pressure at home, limiting red meat, salt, and added sugar intake, and taking prescribed blood pressure medication as directed can help in this regard [11].
Medications: Hormonal birth control pills or long-acting progestin-only contraceptives can help lower the risk of fibroids. On the contrary, however, using birth control pills before the age of 16 might increase the risk [10].
Vitamin D levels: Vitamin D deficiency may increase the risk of fibroids. Therefore, maintaining adequate vitamin D levels can help reduce the risk [11].
However, it's important to note that while these measures can help reduce the risk of fibroids, they may not completely prevent them. More research is needed to fully understand how to prevent fibroids [10].