Usually some variation in the volume of flow and presence of clots do occur from cycle to cycle. However, if you do notice there has been a consistent increase over a number of cycles, then one should consider the possibility of fibroids and endometrial polyps.
Menstrual bleeding comes from shedding of the inner lining (endometrium) of the womb at the end of every menstrual cycle. If there are any factors that may increase the surface area for bleeding, or interfere with the mechanism of clotting (the usual way a person stops bleeding), then a woman may experience heavy menstrual flow.
Fibroids (muscular growths of the uterus) may occur within or near the inner lining of the womb, thereby distorting the normal mechanism of clotting and allowing more surface area for small blood vessels to bleed. Similarly, polyps which are excess outgrowths from the womb lining can also have a similar presentation.
Of course there could be other unusual causes but these are generally quite rare e.g. blood clotting disorders.
Fibroids and polyps can interfere with future pregnancy, since they occupy space within the cavity of the womb and can prevent implantation of the pregnancy. If they are present and significant enough to cause heavy menstrual bleeding, then they should be dealt with, usually with a fairly simple procedure to remove/ cut it out.
An assessment with a pelvic ultrasound scan will help and should be able to detect any significant fibroids or polyps. Hope this helps.
Dr Fong Yoke Fai
