1. Understanding Heavy Menstrual Flow with Clots

   • Heavy menstrual bleeding (menorrhagia) with clots means losing a large amount of blood during periods, sometimes with blood clumps. This can lead to weakness and fatigue due to blood loss.

2. Possible Causes

   • In adolescents, heavy bleeding may be due to hormonal imbalances common during puberty, bleeding disorders, or other underlying medical conditions.

3. When to Seek Medical Evaluation

   • It is important to consult a gynecologist or pediatric specialist to diagnose the cause and rule out serious issues.

4. Diagnostic Tests

   • The doctor may recommend blood tests like a complete blood count (CBC) to check for anemia, coagulation profile to assess bleeding risk, and an ultrasound to examine reproductive organs.

5. Treatment Options

   • Iron supplements to treat or prevent anemia caused by blood loss.
   • Hormonal therapy such as progestogen tablets (e.g., Norethisterone) or combined oral contraceptives to regulate menstrual flow.
   • Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can reduce bleeding and relieve cramps.
   • Dietary changes including iron-rich foods (spinach, lentils, fortified cereals) and vitamin C to improve iron absorption.
   • Herbal teas like raspberry leaf or ginger may help but should not replace medical treatment.

6. Monitoring and Follow-up

   • Regular follow-up with the doctor is essential to monitor symptoms, adjust treatment, and ensure recovery.

7. When to Seek Emergency Care

   • Seek urgent medical help if there is very heavy bleeding causing dizziness, fainting, or if changing pads more than once an hour is needed.

Please consult a gynecologist for personalized evaluation and treatment to ensure your daughter's health and well-being.