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Heavy Menstrual Bleeding: Wolfgang Miesbach Explains the Surprising Link to Clotting
Nov 16, 2025, 05:26

Heavy Menstrual Bleeding: Wolfgang Miesbach Explains the Surprising Link to Clotting

Wolfgang Miesbach, Professor of Medicine at Frankfurt University Hospital, shared on LinkedIn:

“Heavy menstrual bleeding in endometriosis – is it due to blood clotting? Many patients think: “My bleeding is so heavy, can it be a clotting disorder!” But the reality is more differentiated – and in my interview for endometriose-doc.de I try to clarify exactly that! Many thanks to Daniela Frank!

In most cases, there is NO general coagulation disorder.
Instead, it is the additional bleeding endometriosis foci themselves, hormonal changes or completely different causes such as fibroids or thyroid diseases that are responsible for the heavy bleeding.

There are exceptions:

  • Von Willebrand syndrome is surprisingly common in severe endometriosis
  • And some women have TOO MUCH blood clotting ability instead of too little – with a risk of thrombosis!

A game-changer for treatment:

  • NEVER take acetylsalicylic acid (ASA) during heavy menstrual bleeding – this thins the blood!
  • Better: Paracetamol or Novalgin
  • Hormonal therapies must be individually coordinated
  • If you have a family history of thrombosis? Check the thrombophilia parameters!

Every endometriosis is different. Heavy bleeding + nosebleeds + bruises? This could indicate a clotting disorder.

The full interview with a scientific background here.”

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