I’m back this week for some more menstrual Q&A/Myth-busting. I have really loved all the questions you’ve posted over the last two weeks and I promise to do these kinds of posts more often as I know there are a ton of purported truths out there! So let’s get to it!

Can the cause for clotting be unveiled?

I think many women are told that blood clots are totally fine and “normal” (I hate that word) but it depends on a number of factors. These factors include things like:

  • fibroids
  • adenomyosis – can affect the ability of the uterine muscles to contract
  • endometriosis (in some cases)
  • the size of your uterus
  • any obstruction to menstrual blood flow such as polyps etc.

Blood clots are commonly associated with the first three conditions. These conditions are usually a sign that your body is in a state of estrogen dominance – which is really just another way of saying that your body is progesterone deficient. You can read my post about that here.

If you’ve been pregnant, your uterus may remain larger than it was previously, which can cause blood pooling and result in clots. If there are polyps or other growths blocking the regular flow of blood, there is an increased chance for clots as well.

I’d say that clots aren’t necessarily harmful but they could be indicative of something bigger going on, like a hormonal imbalance, especially if they are a new occurrence. I highly recommend seeing your doctor if this is the case for you.

I’d love to know why my PMS symptoms can change so drastically each month.

Why are some months a breeze and others a difficult journey? What causes the variance and is there anything I can do to help them be more consistent?

I love this question because it brings up a whole lot of other questions. I view this time in your cycle as a time in which we are supposed to be winding down from the “busyness” of the ovulatory phase and life in general, but many of us don’t do that. As you may know, traditionally women rested right before and during their periods, but alas that is not the norm anymore.

PMS (premenstrual syndrome) on Red Button.

What I know is the time before and during your period is a time of natural quietness, introspection and self-reflection. Because of hormonal fluctuations during this part of your cycle, you have a heightened sensitivity to external stimuli which leads to irritation, bad moods and all the other emotional “stuff” that comes up. In addition, I believe that you are much more sensitive to all the goings-on of the past month (or however long your cycle was). So in this time of self-reflection (you may not even know this is happening!) you’re getting pissed about something someone said or did to you during ovulation, but it may not have bothered you when it happened.

What you have to do is cultivate an awareness for this time of the month. Make it a special time where you take extra care of yourself and pay attention to what is coming up for you. Could your PMS symptoms be caused by something traumatic that happened during the last month…review your month and find out. Or perhaps you’re in a dead-end relationship or soul-sucking job, you know you need to leave but you haven’t – PMS is your body’s way of trying to get you to pay attention girl!

When I was married, my husband used to say I had the worst PMS. Back then I didn’t know it but I was unhappy with him, my work and the place where I lived. When I made the impossible decisions to move, change my career and eventually get divorced, my “PMS” went away too.

For women with PCOS (like me), with longer cycles (mine is about 50 days), is there a way to tell when you are ovulating or about to ovulate (or if we are ovulating at all)?

I have a temperature shift at the end, but with frequent fluctuations in temperature throughout the cycle. I think I can tell after the fact because I get a temperature shift, but I’m just not sure.

I’d say cervical fluid is the keyword here. Paying very close attention to your unique cervical fluid patterns is probably the best way to know when or if you are ovulating. Taking your temperature is obviously helpful too, but as you stated you can’t tell until after you’ve ovulated and temps can be influenced by sooo many things – including your hormonal imbalance.

You also need to keep in mind that with PCOS, there tends to be an underlying imbalance of too much estrogen and not enough progesterone (because of the lack of consistent ovulation) which means that cervical fluid patterns might not fall under what is considered normal.

Check out my Hormone Myth Busting Pt 1 post from last week and read up on cervical fluid patterns.

In myth buster #5 in the last post, you mentioned that a true period would have a continuous flow.

What does it mean when your period lasts about 5-6 days, yet the flow is not continuous the entire time?

Love this question! Basically everyone is different and I think what is most important to know is your period will probably be quite different to anyone else’s. If you have recently noticed that your period starts then stops, then starts again, this could be indicative of an underlying issue and I suggest seeing your doctor to discuss what might have caused the flow of your period to change. Check out my post on start and stop periods here.

However, if your period has always flowed consistently for 5-6 days, say with a bit of a lull on day 3 or 4, then it’s probably just your unique flow. Usually a period flow is more consistent for the first 2-3 days and then starts to taper off. Sometimes it will stop for a couple of hours or longer and then start back again. Towards the end it could be more spotty and that’s okay too.

If there aren’t any other symptoms involved – clots, severe pain, migraines, extremely heavy flow – then you’re probably fine.

Is low progesterone always connected to something going on with the thyroid?

I always have a clear temp rise but due to other signals in my cycle my doctor is having my estrogen, progesterone, and TSH checked. I got the sense that he added on the TSH test just to be sure and it’s more connected to the corpus luteum not producing enough progesterone. Could you clarify, would that be connected to thyroid stuff or could it stand on its own. Wondering if I need to contact him and push for the T3, T4, and reverse T3 tests if it doesn’t necessarily seem to be a thyroid issue.

I think if there is ever a chance that you have a thyroid issue then you should always push for a full thyroid panel. You can read about thyroid testing and it’s connection to progesterone in this post.

To answer your question, no, low progesterone isn’t always connected to low thyroid function but it is very very common! There are a couple other causes for low progesterone and you can read all about that in this post. Damn, I’ve written a lot of great posts! 🙂

Here are two solutions for low progesterone that you might be interested in.

And that wraps up my mini-series on hormonal myths and commonly asked questions. What else do you wanna know, I love getting new topics for posts. xoxo