Most women may notice clumps or chunks of blood, with a jelly-like consistency when they get their period. These are blood clots. Clots in period blood are common in most women and are nothing to be concerned about. However, it’s also possible that abnormal blood clots in your period blood are the cause of another underlying medical condition. 


What are menstrual clots?


Menstrual clots are made up from blood cells, tissue from the uterine lining, and proteins in the blood that help control blood flow. It is a natural part of the body’s defense mechanism. The thick, jelly-like texture of a blood clot prevents excessive blood from escaping.

Period clots are more common and typically occur during the first 2 days of menstruation, which is usually when the flow is at its heaviest. Period clots can be bright in color, or a darker, deeper red. They look similar to the clumps of fruit you may sometimes find in jam. Clots begin to appear darker and brownish towards the end of each period, compared to the first few days of your period in which clots may be bright red and tend to be bigger. This is because there is a larger amount of blood sitting in the uterus, blood flows at a faster pace. and doesn’t have time to darken; while towards the end of the period, blood is older and leaving the body slower. The cervix has to dilate a bit in order to pass larger blood clots, which may cause intense pain or cramps.


Normal vs Abnomal – What are the causes?


Physical as well as hormonal factors can affect the menstrual cycle, thus, creating a heavy flow, which in turn, increases the occurrence of period clots. While it is normal to have blood clots during menstruation, this may signal an underlying medical condition. Abnormal blood clots tend to be larger than a quarter in size, and occurs regularly. It is advisable to seek medical help if you experience any of the symptoms above accompanied by heavy menstrual bleeding. Bleeding is considered heavy if you are required to change your tampon, or sanitary pad every two hours or less.

There are a variety of problems that could be increasing the volume of your menstrual flow and/or causing abnormally large clots to form, depending on your age and medical history. Abnormal menstrual clots can be caused by the following conditions:


  1. Uterine polyps or fibroids
  2.  Endometriosis
  3. Adenomyosis
  4. Hormonal imbalances
  5. Pregnancy loss/ Miscarriage
  6. Enlarged uterus
  7. Bleeding disorders
  8. Cesarian scar
  9. Uterus or cervix cancer

Diagnosis


The cause of period clots can be diagnosed by a doctor. The healthcare provider will ask you about factors that affect menstruation, for example:

  1. How long does your period last?
  2. How heavy is your usual flow?
  3. Have you noticed any changes in your flow over time?
  4. Have you been pregnant before?
  5. Have you ever had pelvic surgery?
  6. Are you on birth control? If so, what kind?
  7. What medications are you on?

After that, a pelvic exam will be conducted. Some doctors may want to do some other tests to determine the cause of the abnormal menstrual clotting.


Treatments


Finding out the cause will allow the doctor to recommend the most appropriate cause of treatment. Controlling heavy period bleeding is the most effective way to control clots.

Treatments include:

  • Hormonal contraceptives

Some contraceptives can help in reducing menstrual blood flow and regulate irregular bleeding. Hormonal IUDs or birth control pills are two common suggestions made by healthcare providers.

  • Ibuprofen

Taking Advil or Motrin (ibuprofen) during your period can significantly reduce pain, cramping, as well as the amount of bleeding by up to 49%. Even though aspirin is also a non-steroidal anti-inflammatory drug (NSAID), however, consuming it can increase your blood flow.

  • Hormonal therapy

Progesterone, estrogen, or a mixture of both can help reduce menstrual bleeding. The main difference between hormonal therapy and hormonal contraceptives is that hormonal therapy preserves fertility, best suited for women who are trying to conceive but would also like to control their heavy menstrual bleeding.

  • Antifibrinolytic Medicine

The main function of antifibrinolytic medication is to slow down the process of breaking down blood clots. Antifibrionolytic medications, such as Lysteda (tranexamic acid) or Amicar (aminocaproic acid) can reduce bleeding by up to 58%.

  • Surgery

Surgery is required when polyps or fibroids have to be removed. Doctors may also recommend surgical treatment if the prescribed medication is not effective.


Doctors may advise taking iron supplements to restore iron levels if the patient may be at risk of anemia or has been losing too much blood. The iron supplements will not decrease blood flow, but it may treat the symptoms of anemia and help to replace healthy red blood cells. Actions such as staying hydrated, avoiding aspirin, doing regular physical activity are also highly encouraged.



Menstrual clots are a natural part of a woman’s reproductive life. You know your body better than anyone else. If you notice or sense something off or different than usual, seek help from a doctor as soon as possible. It is highly encouraged to keep track of your period changes each month as the information will be extremely helpful for your doctor in effectively diagnosing the cause and providing the best treatment