Q: Good evening. Merry Christmas and happy New Year in advance. Please if someone has black blood menstruation, can it cause delay to get pregnant and if the menstruation is not heavy flow again, can it cause delay to get pregnant? Thanks
A: Merry Christmas and Happy New Year!
For menstrual period, there are usually differences from one woman to the other and even from period to period in the same person.
The uterus (womb) usually prepares to receive a fertilized egg every month and when that fails, the thickened lining of the uterus which had prepared to receive a baby is shed. Usually, this blood does not contain clots as anti-coagulants (substances that prevent clotting of blood) in blood ensure that this doesn’t happen.
However, if the blood is flowing faster than the anticoagulants can work, then clots appear. This would usually happen on the heaviest day of the flow as appears to be the case here. So, clots do not necessarily suggest a problem.
But, if this appears to be the case on all or most days of the period, or you find that you’re using a sanitary towel per hour for several hours, please see your gynaecologist. Conditions that may lead to excessive bleeding and therefore, clots in blood during a menstrual period include a miscarriage (of a pregnancy), fibroids, dramatic recent weight loss, thyroid problems, large uterus etc If this is further accompanied by feeling of faintness, tiredness and paleness, you should head to the hospital immediately.
Towards the end of a period, the blood usually becomes dark due to older blood not being expelled fast enough from the body. It is not usually a cause for concern and should not prevent pregnancy. If, however, the clots are present all through the menstrual period, please see your doctor. Better safe than sorry.
Issues that can cause a decrease in flow include pregnancy (the supposed period may be an implantation bleed), crash dieting (when you want to lose all the weight you added in 5 years in one week :D), intense physical activity, Polycystic Ovary Disease (PCOD), imbalance of hormones and use of contraceptives. Previous instrumentation like Dilatation and Curettage (D and C), where the procedure was too ‘vigorously’ done can result in a condition called Asherman’s syndrome which manifests as reduction in menstrual flow. In the same way that stress can delay a menstrual period, it can also cause a reduction in flow.
You must work with your gynaecologist in order to manage this. If the cause is PCOD, focus will be on the treatment; if due to intense exercise, reducing intensity will be helpful; if due to crash dieting, focus on eating a proper balanced diet will help etc. Your gynaecologist will carry out a detailed examination and investigation to arrive at the cause and advice on treatment.
All the best
I hope this helps.