Blood Clots During Period – Causes, Signs, Risks, Diagnosis

As a woman, you may experience some embarrassing – and sometimes gross – things during your period. Uncomfortable as it is to talk about, changes in the heaviness of your flow and clots can be an indication that something is wrong.

Before you start panicking, know that it’s normal to see clots on your heaviest days. It’s the size of the clots that you should be concerned about. We’ll explain what causes clots and when you should be concerned about them during your period.

What Causes Blood Clots?

In general, blood clots can be caused by a variety of things, including:

  • Family history
  • Heart arrhythmias
  • Antiphospholipid syndrome
  • Arteriosclerosis
  • Factor V Leiden
  • Deep vein thrombosis
  • Polycythemia vera
  • Peripheral artery disease
  • Obesity
  • Heart attack
  • Heart failure
  • Pregnancy
  • Certain medications
  • Surgery
  • Smoking
  • Pulmonary embolism

That’s quite a long list of potential causes. Clots that form in the small veins close to the surface of your skin are generally harmless, but if clots break away from their original source, they can cause health issues (some life-threatening).

Are Menstrual Blood Clots Normal?

Yes, they can be. Most women will experience clots during their period at some point in time. Many women pass small clots as a normal part of their period.

However, when clots are larger than a quarter in size, you should see your doctor as this is an indication of a potential medical issue.

Signs of Period Blood Clots

What are period blood clots? How do you know if you’ve passed clots?

Period blood clots are:

  • Most common during the first few days of your period – the heaviest days.
  • A thick mass of blood. Clots often look like jam.

Clots can vary in consistency and color. They’re typically dark or bright red, and they may make your flow thicker or denser.

Most clots are small in size  and are usually only present during the first few days of menstruation. If you’re still seeing clots towards the end of your period, there may be an underlying medical issue that needs immediate attention.

What Causes Large Blood Clots During Period?

During menstruation, the lining of your uterus sheds – sometimes at a rapid pace. When you start bleeding, anticoagulants are released to help break down your flow before it leaves your body. But during your heaviest days when your flow is thicker than normal, blood is expelled from your body at a much faster rate. When this happens, the anticoagulants don’t have time to work, and clots can form.

Clots that are larger than a quarter are often an indication of heavy bleeding and may be a symptom of a medical issue.

Causes and Risks of Heavy Bleeding During Period

If you experience a heavy period with clots, see your doctor as soon as possible.

What’s considered heavy bleeding?

  • Soaking through a pad or tampon every 2 hours
  • Passing blood clots that are larger than a quarter
  • Menstrual bleeding that lasts longer than 7 days

If left untreated, heavy bleeding can eventually cause anemia, a condition that causes weakness and fatigue.

Causes of Heavy Bleeding

  • Hormone imbalances
  • Uterine fibroids or polyps
  • Certain birth controls, like IUD devices
  • Uterine or cervical cancer
  • Pregnancy issues, such as a miscarriage or ectopic pregnancy
  • Bleeding-related illnesses and diseases
  • Other diseases and illnesses, including thyroid disease, PID and cancer
  • Certain medications, such as aspirin, which can increase bleeding

Diagnosing Heavy Bleeding

It can be difficult to diagnose heavy bleeding as each person has a different idea of what “heavy bleeding” is.

Under normal circumstances, bleeding lasts about 4-5 days, and only 2-3 tablespoons of blood is lost. However, women with heavy bleeding will bleed for 7 days or more and lose twice the normal amount of blood.

If you find yourself having to change your pads and tampons every two hours or more often, you need to see your doctor right away.

Your doctor might ask you a series of questions to diagnose heavy bleeding, such as:

  • How long does your menstrual cycle typically last?
  • When did you get your first period?
  • How many days would you say you experience heavy flow?
  • How many days does your period last?
  • Is your period affecting the quality of your life?
  • Does anyone else in your family suffer from heavy bleeding?

If you’re unable to answer some of the questions above, your doctor may ask you to track your periods in a journal. Write down the dates of your period and the heaviness of your flow in this journal.

If your doctor suspects that you might have a bleeding disorder or other medical condition, he or she may recommend getting the following tests:

  • Pap test: Cells from your cervix will be examined to see if you have inflammation, an infection or cancer is causing the issue.
  • Blood test: A blood sample will be checked for thyroid issues, anemia, or other issues that affect blood clotting.
  • Ultrasound: An ultrasound will let your doctor check your blood flow.
  • Endometrial biopsy: Samples from your uterus will be taken to see if you have abnormal cells or cancer.

Do Blood Clots Need to Be Treated?

In most cases, blood clots are completely normal during your period and don’t require any treatment.

But if you’re passing clots that are larger than a quarter or are soaking through your pads or tampons quickly, your doctor may recommend a variety of different treatments to remedy the problem. If left untreated, it could lead to serious or life-threatening medical issues.

Common treatments for heavy bleeding include:

  • Ibuprofen: Reduces bleeding and menstrual cramps.
  • Iron supplements: If you’re showing signs of anemia, your doctor will recommend taking iron supplements to ensure your blood is carrying enough oxygen.
  • Birth control: For some women, birth control can regulate and normalize periods.
  • Hormone therapy: May be recommended if hormonal imbalance is the cause of heavy bleeding.
  • IUC: A contraceptive device that is placed into the uterus. An IUC can regulate periods and reduce bleeding.
  • D&C (Dilation and Curettage): A surgical procedure that removes the top layer of the uterus to reduce bleeding.
  • Hysterectomy: Only recommended in severe cases. This procedure removes the entire uterus. After a hysterectomy is performed, you can no longer get pregnant and will not get your period.

Heavy bleeding is a common issue that many women face. If any of the symptoms apply to you, you’re not alone. But there is help out there, and you don’t have to let your period affect the quality of your life. If you’re passing large clots and bleeding for more than 7 days, see your doctor to get treatment and prevent complications in the future. Remember, clots are normal, but if they’re larger than a quarter, you should see a doctor right away.