Blood Clots During the Period: Is it Normal?

Menstrual clots (blood clots in period blood) are something that happens to a lot of women during their period. Doctors often called them menstrual coagula. They are like jelly-like blobs of blood cells or tissues from the uterus lining and a protein called fibrin that helps blood clot. Menstrual clots can be of various sizes, shapes, and colours, ranging from small and inconspicuous to larger, more noticeable clumps. The formation of menstrual clots is a normal part of the menstrual cycle for many women. Many of us may have a few questions surrounding menstrual clots: What are the reasons for blood clots in periods? Do they denote something wrong in my body? When should I consult a doctor? Let us answer these questions one by one.

Are blood clots during the period normal?

For most of us, menstrual normalcy means period but no blood clots. It can be surprising and unsettling to notice thick globs of menstrual blood, but here's something reassuring: usually, blood clots are normal in periods. They don't necessarily indicate a problem, although occasionally it might be a sign of an underlying health condition. The human body has a built-in defence mechanism for menstrual clots' thick, jelly-like texture. This mechanism prevents too much blood from escaping.

It is our body's way of taking care of itself, similar to clot formation when there's an injury to tissues, like a cut or laceration. These menstrual clots are common when the flow is heavier during the first two days of menstruation. These clots can come in different colours, ranging from bright red to a deeper, darker shade. Larger clots may even appear black. Towards the end of each period, the menstrual blood might take on a darker, more brownish hue as the blood becomes older and leaves the body at a slower pace.

How Do We Differentiate Between Normal and Abnormal Clots During the Period? 

Many of us may find it difficult to distinguish between what's considered "normal" and what might be a cause for concern when it comes to menstrual clots. 

If you come across small clots happening occasionally, you do not need to worry about it. These smaller bright or dark red clots are usually common in the menstrual cycle.

On the other hand, if you regularly experience larger clots that exceed the size of a quarter more frequently, it could indicate an underlying medical condition.

What are the Causes of Clots During the Menstruation Period? 

Menstrual blood generally forms clots in the uterus or vagina. It is similar to the clotting on an open skin wound. The thickness of menstrual blood varies throughout the menstrual cycle and from one period to another. It is normal if your flow is heavier with clots in one month and lighter and no clots in the other. These are common and natural in menstrual cycles. Heavy periods with clots can also be due to many diseases, like:

• Endometriosis, which involves the growth of uterus lining cells (endometrial cells) outside the uterus, can cause symptoms like painful periods, nausea, discomfort during sex, infertility, pelvic pain, and abnormal bleeding, which may include clotting.
• Adenomyosis results from the uterine lining growing into the uterine wall, enlarging and thickening the uterus. This can cause prolonged and heavy bleeding.
• Cancerous tumours in the uterus and cervix can cause heavy menstrual bleeding.
• An imbalance in estrogen and progesterone hormones can lead to heavy menstrual bleeding. Causes include perimenopause, menopause, stress, and significant weight changes.
• Many a time, the pregnancy may end in miscarriage, often before the person is aware they are pregnant. Early pregnancy loss can result in heavy bleeding, cramps, and clotting.
• While rare, Von Willebrand disease can cause heavy menstrual flow. If you experience regular heavy menstrual bleeding and easy bleeding tendency after minor cuts or abnormal gum bleeding, consult a doctor to explore the possibility of VWD.

What are the Main Complications of a Heavy Bleeding Period With Clots?

Heavy menstrual bleeding can result in:

• Iron deficiency anaemia causes fatigue, weakness, paleness, shortness of breath, and chest pains
• Sudden muscle cramps
• Intense abdominal and back pain
• Worsening of the gynaecological issues (like fibroids, adenomyosis, endometriosis, polyps)

Is Diagnosing the Cause of Heavy Blood Clots During the Period Possible?

Yes, it is possible to diagnose the reason for clots in periods. Your doctor may ask you questions related to your medical history. They may also perform a physical exam and ask about blood clotting during the period's symptoms. 

Diagnostic tests:

• Blood tests - check anaemia, hormone levels, and bleeding disorders
• Ultrasound or other imaging tests - determine the cause of large blood clots during the period
• Endometrial biopsy - Sometimes doctors perform a biopsy to check the uterine lining

What Is the Treatment of the Problems Related to Period Blood Clots?

Treatments include:

• Medications:
  • Hormonal contraceptives (like progestin releasing IUDs or birth control pills) control heavy menstrual bleeding and menstrual clots
  • Tranexamic acid stabilises blood clots
• Surgery: Sometimes doctors may suggest surgical options: 
  • Dilation and curettage (D & C) for diagnostic or temporary relief 
  • Myomectomy - removal of uterine fibroids
  • Hysterectomy - removal of the whole uterus

When Should I Consult With the Doctor for Menstrual Clots?

If you experience large blood clots exceeding the size of a grape, it's advisable to seek prompt medical advice. Large blood clots is common sign of a heavy period. This may indicate an underlying and potentially serious medical issue. When your period is unusually heavy, leading to the need to change a pad or tampon every hour for an extended period, consulting with your doctor becomes essential.

FAQs

1. What Do Big Blood Clots Mean in the Period?

Large blood clots during menstruation may signify a heavy flow. 

2. Why Am I Passing Blood Clots Between Periods?

Passing blood clots between periods may be due to blood accumulation or hormonal changes, or it could indicate an underlying medical issue that requires attention.

3. When Are Period Clots Abnormal? 

Period clots are considered abnormal if they are huge and occur frequently.

4. How does a bad period clot look like?

Unhealthy period clots are usually huge, thick, jelly like or may be accompanied by severe abdominal pain. You should consult your doctor if you experience any of these symptoms.