What might cause heavy periods with clots in women over 40?

Reviewed by Yoshinori Abe, MD

Internal Medicine

Heavy periods with clots in women over 40 are common and can result from several causes. Hormonal shifts during perimenopause, uterine fibroids, endometrial polyps, adenomyosis, thyroid disorders, or bleeding disorders may all contribute. In some cases, heavy menstrual bleeding with clotting can signal a more serious condition, such as endometrial hyperplasia or, rarely, uterine cancer.

Because the causes vary widely, identifying the right next step can feel overwhelming. A free, instant, online symptom check can help you clarify possible causes based on your specific symptoms, guide you on when to see a doctor, and prepare you with the right questions—so you can take control of your health quickly and confidently.

Reviewed for medical accuracy: 07/14/2026

Important Next Steps

Learn if heavy periods need urgent care Discover likely causes of heavy clotting periods See whether your bleeding suggests menopause changes Find OTC options for heavy period relief Find a gynecologist for heavy bleeding Understand medically proven home remedies for heavy periods Find out if heavy periods signal something serious

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Explanation

Heavy periods, also known as menorrhagia, can happen for different reasons in women over 40. As women age, their bodies undergo hormonal changes that can affect menstruation. Here are some possible causes:

Hormonal Changes: As women approach menopause, the balance of hormones like estrogen and progesterone can change, leading to heavier periods.
Uterine Fibroids: These are non-cancerous growths in the uterus that can cause heavy bleeding and clots.
Other Medical Conditions: Conditions like bleeding disorders can also contribute to heavy periods.

Understanding the exact cause of heavy periods requires a medical evaluation, which can help in choosing the best treatment options. If you experience heavy periods, it may be helpful to keep track of your menstrual cycle and any symptoms you experience, or you can check your symptoms to get personalized insights before discussing them with a healthcare provider.

(References)

Brenner PF. (1996). Differential diagnosis of abnormal uterine bleeding. American journal of obstetrics and gynecology, 8828559.
Blum M, & Blum G. (1992). The possible relationship between menorrhagia and occult .... Advances in contraception : the official journal of the Society for the Advancement of Contraception, 1290333.
Kadir RA, Sabin CA, Pollard D, Lee CA, & Economides DL. (1998). Quality of life during menstruation in patients with inherited .... Haemophilia : the official journal of the World Federation of Hemophilia, 10028306.

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