Does Endometriosis Cause Clotting in Menstrual Blood?

During the menstrual period, which usually begins at the age of 11-14 and continues until women enter the menopause, blood and mucosal tissue are expelled from the endometrium layer of the uterus (the innermost layer of the womb) at intervals of approximately one month, if pregnancy does not occur. Although noticing clots in menstrual blood sometimes causes concern, this is usually a normal situation. During menstrual bleeding, the endometrial cells that cover the inner wall of the uterus are shed and leave the body.

At this time the body releases proteins that cause the blood in the uterus to clot. This clotting prevents the blood vessels in the inner wall of the uterus from continuing to bleed. The blood that leaves women’s bodies also contains these clotting proteins. At times when the flow is heaviest, the clotting proteins in the blood beginning to gather together can cause clotting in the menstrual blood. This usually appears with the menstrual blood collecting in the uterus or the vagina before being expelled from the body. Along with this, abnormal bleeding and the appearance of blood clots may be in question in the conditions of endometriosis and adenomyosis, which women frequently experience. Of the diseases that arise from uterine (womb) tissue developing because of growth in an area other than the inner wall of the uterus, in endometriosis the endometrial tissue develops abnormally outside the uterus, and in adenomyosis inside the muscle of the womb.

The intensity of the symptoms can vary in patients with endometriosis. Among the classic symptoms of endometriosis are pain, pain during or after sexual intercourse, infertility and painful bowel movements. Because these symptoms may also be a sign of other conditions, a specialist should definitely be consulted. In some cases endometriosis does not show any symptoms and can be diagnosed by chance during a doctor’s examination. Drug or surgical options can be used in the treatment of endometriosis, or patients who do not have a clinically significant complaint may simply be observed. Although a chocolate cyst can shrink with drug therapy, it does not disappear, it does not vanish.  Mostly the aim is for its diameter to shrink to some extent, at least not to grow, and, more importantly, for the patient’s complaints clinically to pass or to be reduced enough not to affect her life. With drug therapy the aim is to prevent recurrence and to reduce the complaints. Sometimes drug therapy can also be applied before the surgical procedure in order to shrink the cyst before the operation and make the operation easier.

As for the surgical procedure, Closed Surgery (Robotic surgery or Laparoscopic Surgery) is usually applied. Today, apart from very exceptional situations, open surgery is not used in endometriosis surgery. Because of its structure, a chocolate cyst attaches to the ovary much more strongly than a normal cyst does. If too much force is applied, a situation such as the removal of the ovarian tissue may be faced. Therefore, in Endoscopic Surgery it is very important to separate the Chocolate Cyst gently from the healthy ovarian tissue and to protect the remaining healthy tissue well.