Kate is a mother of two and holds a Bachelor of Science (B.S.) degree from Sonoma State University. She's also a passionate researcher.
It’s that time of the month again! This time, however, you notice clots in your menstrual blood. This experience can be scary for most women, but should you worry? A lot of women do, so let’s discuss what period clots are, why they happen, and when you should visit a physician to assess your overall health.
A fact you should be aware of is that period clots happen to most women at some point in their lives. Menstrual clots are the gel-like substance you see on your pad or tampon – a by-product of the blood secreted from the uterus as you menstruate. Some women expel a dark, red substance, while others see bright, crimson spots.
Differentiating Normal Clots From Unusual Ones
You shouldn’t worry if the clots aren’t any bigger than a quarter and only occur occasionally. Clots that are expelled out of the body aren’t usually dangerous, unlike the ones that form in the veins.
However, if the gel-like secretion becomes a regular thing during your period, it could be a sign that something is wrong and that it needs to be checked by a medical professional.
If you happen to have heavy menstrual flow accompanied by large clots, it’s time to see your doctor. Note that excessive pad or tampon change (less than two hours) is a sign of heavy menstrual bleeding. If you’re pregnant – or suspect that you are – and you suddenly expel blood clots, see your doctor immediately.
Signs of Normal Period Clots:
- Smaller than the size of a quarter.
- Only expelled rarely during the course of your period.
Signs of Abnormal Period Clots:
- Larger than the size of a quarter.
- Expelled throughout the course of your period.
- Large clots accompanied by heavy blood flow (pad or tampon changes more than every two hours).
- Any clots occurring during pregnancy.
Why Do Period Clots Occur?
The endometrium, or the uterine lining, sheds approximately in every 28 to 35 days, a process we call menstrual period, menstruation, or simply a period. This happens when the thickened uterine lining did not “detect” a fertilized egg.
When the uterine lining sheds, blood is expelled along with tissue, mucus, and blood by-products. It passes through the uterus to the cervix, then out of the vagina.
Before the shedding gets expelled from the vagina, it gathers at the bottom of the uterus first, waiting for the cervix to contract before releasing menstrual blood. However, uterine lining shedding isn’t exactly easy to expel because of its thick texture.
The natural response of the female body is to release anticoagulants so the blood becomes thin enough to pass easily out of the vagina. There are times, however, that the flow of the blood overwhelms the body’s capacity to release anticoagulants. This is why you spot a menstrual clot.
Women with light to normal heavy menstrual flow don’t usually have menstrual clots – it’s the heavy bleeders that often have this especially during the first or second day of the period. If your menstrual flow is thicker than usual and you see clots during the entire duration of your period, there may be a more serious underlying cause other than the shortage of anticoagulants.
What Could Be Causing Your Period Clot?
Heavy menstrual bleeding and menstrual clots often go hand in hand, and if you’ve been having both, here are the possible reasons:
About 10 to 20 percent of known pregnancies end in miscarriage1, and more than 80 percent of these losses happen before 12 weeks, including women unaware that they are actually pregnant. When a miscarriage happens during early pregnancy, it could be easily mistaken for heavy menstrual flow, and thus clotting can be spotted along with cramping.
The uterine lining involves both progesterone and estrogen to be balanced for it to thicken. If either of these two hormones are a little too high or too low, it would likely result in heaver blood flow. One obvious sign of hormonal imbalance in women is irregular menstruation, which is often caused by abrupt weight loss or gain, stress, menopause, and perimenopause.
Uterine or Cervical Tumor
Your period clots could be a sign there's a tumor present in your cervix or uterus. Some cases of cancerous tumors in a woman’s reproductive system are often discovered when unusually heavy blood flow is experienced.
Adenomyosis occurs when endometrial tissue, which normally lines the uterus, exists within and grows into the muscular wall of the uterus. This disease causes bloating, pressure or pain in the abdomen, and menstrual cramps that often result in heavy periods.
When the tissue that’s supposed to grow inside of the uterus grows outside and into the reproductive tract, endometriosis occurs. This abnormality is often dismissed as a simple case of menstrual cramps, but if left unchecked, it could lead to pain during sexual intercourse, nausea and vomiting, diarrhea, and clotting.
Fibroids are more common than you think. In fact, it is experienced by up to 70 percent of women before they reach the age of 50.2 Fibroids are when noncancerous tumors grow along the walls of the uterus. It can cause heavy menstrual flow, and with it comes pain in the abdomen and lower back, larger than usual belly, pain during sex, and possibly fertility issues.
Menstrual Clot Complications
If you’ve been noticing regular onsets of period clots, it’s best to check with your doctor. Most women often dismiss clotting, but one complication it could lead to is iron deficiency anemia because of abnormal heavy flow. If you are experiencing the signs and symptoms listed below, you may be suffering from this complication.
Signs of Iron Deficiency Anemia:
- Chest pains
- Shortness of breath
- Pale skin
If you believe you may be suffering from anemia, it is important to consult with a physician. Typically, it will be necessary for a medical professional to ask you a significant number of questions revolving around your menstruation in order to diagnose you.
Disclose any information that will help in the proper diagnosis and treatment such as birth control use, pelvic surgeries in the past, or if you’ve been pregnant before. A checkup may also include an ultrasound of your uterus and blood tests.
Are Period Clots Treatable?
It’s not exactly a treatment per se, but more of a prevention. To prevent menstrual clots from happening, heavy menstrual flow should be controlled first.
Abnormal amounts of menstrual blood can be controlled by way of contraceptives. Birth control pills often minimize blood flow up to 50 percent, while IUD devices can do so up to 90 percent. Another benefit of hormonal contraceptives is to inhibit the growth of fibroids and adhesions within the uterus.
For more serious conditions, such as heavy blood flow caused by childbirth or miscarriage, Dilation and Curettage (D and C) surgery may be performed. This surgery involves dilating the cervix and scraping or scooping the lining of the uterus to reduce thickening.
While bleeding after a miscarriage or childbirth is normal, D and C may be used to find out what causes heavy flow and provide probable treatment options for a variety of medical conditions.
Other surgical methods that can be applied to control heavy menstrual flow are laparoscopy and myomectomy. Both involve incisions to access the uterus to remove abnormal growths. There is also an option to remove the uterus fully, a type of surgery called hysterectomy.
Dealing with Heavy Menstrual Flow
As period clots come with heavy menstrual flow, women should be aware that blood by-products may or may not be dangerous, and thus should take steps to deal with their heavy menstrual flow.
Managing heavy menstrual flow is challenging and can cause a disturbance to daily activities, but you don’t have to suffer because there are simple methods for dealing with it.
- Always bring menstrual supplies anywhere you go. Aside from tampons and pads, carry vaginal wipes and other toiletries for hygiene.
- At night, protect your sheets using a towel or a waterproof pad.
- When out during a heavy flow, wear dark shades of clothing in case a leak happens.
- Always be on the lookout for public restrooms so you can do a quick pad or tampon change.
- Since heavy blood flow can cause iron deficiency anemia, make sure you take care of your health. Eat a well-balanced diet and get enough rest so you can go back to your daily activities.
Supporting Uterine Health
Although there may be serious reasons for period clotting, yours could just be a usual case of anticoagulants not working properly. Hormonal imbalances in women are common and most cases can be attributed to stress.
Addressing stress means having to overhaul one’s lifestyle to get your menstruation back to normal. A clot in your pad or tampon can be alarming, but allow your body to naturally cleanse itself first before resorting to the thought that “something is wrong.”
Period clots may appear different from cycle to cycle, but if it’s starting to worry you, go ahead and talk to your doctor about it. Professional advice is always the best advice.
1. "Miscarriage: Signs, causes, and treatment" (n.d.) BabyCenter. Retrieved February 19, 2018.
2. "Uterine Fibroids" (n.d.) U.S. Department of Health & Human Services. Retrieved February 19, 2018.
3. "Menstrual blood problems: Clots, colour and thickness" (n.d.) WebMD. Retrieved February 19, 2018.
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2018 Kate Daily