Are Blood Clots During Menstruation a Cause for Concern?

The intensity of menstrual bleeding varies from woman to woman and from month to month. While some women go through “those days” with ease, engaging in their usual activities, others notice what appear to be literal “pieces of flesh” during their period. These are not actual “pieces of flesh,” but blood clots that can vary in size. Blood clots during menstruation can alarm both younger girls and older women, especially if they are larger than usual. In most cases, this is a completely normal occurrence. But what if it’s not?

The experts at IntroLab, one of the best laboratories in Belgrade, can help determine why blood clots occur during menstruation and when they might indicate something more serious.

Are blood clots in menstrual blood normal?

Yes, blood clots are usually a normal part of menstruation. They consist of clotted blood and tissue expelled from the uterus and have a gel-like consistency. They can resemble cooked strawberries or the fruit lumps in jam and can vary in color from bright red to dark red.

Why do blood clots occur during menstruation?

Under the influence of hormones, the uterine lining sheds, resulting in menstruation. In this process, small blood vessels begin to bleed. To prevent excessive blood loss, plasma and platelets work together to create blood clots, known as menstrual clots.

Blood clots form when blood stays in one place for a while. During menstruation, the blood can accumulate in the uterus and form clots before it exits the body, similar to how blood clots form when you get a cut.

Smaller pieces of clotted blood exit the body relatively easily. However, the cervix must widen for larger blood clots to pass through, which can cause more intense pain. If you experience heavy bleeding and stronger cramps, these clots might be the reason for your discomfort.

A woman is lying on the bed because of stomach pain due to heavy bleeding accompanied by blood clots during menstruation.
Large blood clots during menstruation could be the cause of your pain.

When are blood clots during menstruation a cause for concern?

If you have heavy menstrual bleeding with clots, does it mean something is wrong? It can, but not always.

For instance, heavy bleeding with clots the size of coins during your period can be normal for some. The issue arises if you have clots the size of a ping pong ball that appear every few hours. It’s also a concern if you need to change your pad or tampon every hour, which indicates a significant amount of bleeding. Losing that much blood can lead to low blood pressure and potentially anemia.

However, if heavy bleeding happens once during a cycle and doesn’t recur, it is less concerning. Pay attention to the pattern – how often your periods are heavy and how long it lasts.

If you notice unusually large blood clots during your periods, this could indicate a problem. The question is – what might be causing it?

Some of the most common causes are:

  • Thyroid disease
  • Uterine polyps
  • Uterine fibroids
  • Blood clotting disorders due to acquired or hereditary thrombophilia factors
  • Uterine or cervical cancer
  • Polycystic ovary syndrome (PCOS)

Pregnant women might also notice blood clots. These are not menstrual clots, but it is important to see a doctor if they occur. Clots during pregnancy can be a sign of miscarriage or an ectopic pregnancy, both of which can be life-threatening.

A female gynecologist is pointing to something on a model of the female reproductive system.
Consult a doctor if you notice irregularities in your cycle.

When to see a doctor?

Blood clots during menstruation are a normal part of your cycle. However, if you notice changes in their size or quantity, it’s time to see a doctor. When discussing this with your doctor, be prepared to answer the following questions:

  • How long does your usual cycle last?
  • How heavy is your bleeding?
  • Do you experience bleeding between periods?
  • Have you noticed changes in the intensity of bleeding or the amount/size of clots?
  • Have you experienced unusual pain?
  • Are you pregnant?
  • Are you taking any medications, and if so, which ones?
  • Do you have any hereditary or chronic diseases?

Your doctor will likely perform a gynecological exam, and possibly a Pap test and ultrasound. They may also recommend certain biochemical tests (e.g., thyroid hormone levels, iron levels), hemoglobin electrophoresis if anemia is suspected, and possibly genetic testing if your family history indicates it.

How to manage large blood clots during menstruation?

For treating large clots, your doctor may recommend the following options based on your examination, test results, the severity of the clots, and other symptoms:

  • Contraceptive pills
  • Nonsteroidal anti-inflammatory drugs (e.g., ibuprofen)
  • Tranexamic acid
  • Hormone therapy
  • Surgical intervention
A blister pack of contraceptive pills.
Contraceptive pills might be included in your treatment plan.

Consult a doctor if you suspect something is wrong!

Blood clots during menstruation can seem concerning, but they are usually normal, and most women experience them at least once. They often occur during heavier bleeding, especially in the first few days of menstruation. However, large clots (bigger than a coin) accompanied by heavy bleeding might indicate something more serious. If you notice these, especially if they are recurrent and come with additional symptoms, do not hesitate to seek medical help. Your doctor will advise you on the next steps and provide guidance on managing your bleeding or prescribe appropriate treatment to regulate the clots.

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