Understanding Period Blood Clots: Normal vs. Abnormal Clotting

Understanding Period Blood Clots: What's Normal and When to Worry

Passing blood clots during your menstrual period can be alarming. But small clots are usually natural and harmless. What do normal period clots look like? And how can you tell when clotting becomes excessive or problematic? Keep reading for a complete guide to period clots, accompanied by photos so you know what to watch out for.

What Causes Clots During Your Period?

Some clotting is normal during menstruation thanks to changes in your uterine lining and hormone levels.

Your period comes from the shedding of the endometrium, the tissue lining the uterus. This tissue and blood fills small vessels called sinuses. When the sinuses contract to push out the lining, clots can form from the blood and tissue debris.

Estrogen makes blood clot more easily. Right before your period, estrogen drops rapidly. This allows more blood to leave the uterus and flow out through the vagina. The changing estrogen levels during your cycle facilitate both period bleeding and clotting.

What Do Normal Period Clots Look Like?

Small clots are simply coagulated bits of the uterine lining mixed with blood. Here's what typical, harmless period clots look like:

• Size of a quarter or smaller
• Dark red or maroon color
• Gelatinous, shiny or rubbery texture
• Round or oval shape
• Similar thickness throughout

These dime to quarter-sized clots will often slide out into your underwear or the toilet bowl. They may stretch a bit like rubber before breaking apart. Small clots frequently shed for the first few days of heavier flow.

Benign Causes of Menstrual Clotting

You may notice more or larger clots under the following normal circumstances:

• Heavy flow - More blood loss allows bigger clots to form.
• First period day - Flow needs to push through buildup leading to clots.
• Missing periods - More endometrial tissue will shed after a gap in cycles.
• Birth control changes - New methods can impact bleeding and clotting.
• Exercise - Movement can dislodge blood clots from the vagina.

As long as clots remain smaller than a quarter, these common influencers aren't cause for concern.

When to Worry About Period Clots

Though usually normal, large blood clots or clotting that persists all week could indicate an underlying problem. See your gynecologist if you notice:

• Clots larger than one inch
• Long stringy clots
• Bright red clots
• Severe clots daily during your period
• Heavy bleeding plus dizziness, weakness, or fatigue
• Sudden change in clot amount from your norm

These signs point to heavier, abnormal uterine bleeding that may require treatment. Don't ignore persistent heavy clots month after month.

Underlying Causes of Abnormal Clotting During Periods

See your OB-GYN if you routinely pass large, frequent clots to identify any underlying problems. Possible medical causes include:

Fibroids

Noncancerous fibroid tumors in the uterus can lead to heavier menstrual flow and clotting. Fibroids may need surgical removal if they cause excessive bleeding.

Adenomyosis

When the uterine lining grows into the uterine muscle layers, it causes very heavy flow with clots. Anti-inflammatories and hormonal medications help treat adenomyosis.

Endometriosis

Endometrial tissue growing outside the uterus linked to endometriosis increases menstrual flow and clotting. Hormone therapy or laparoscopic surgery can treat endometriosis.

Polyps

Small, benign polyps on the uterine lining commonly cause abnormal bleeding and large clots. They can be removed via hysteroscopy.

Hormonal Imbalances

Hormonal conditions like polycystic ovarian syndrome (PCOS) or thyroid disorders can create hormone imbalances. This leads to heavier, irregular periods with clotting. Hormone therapy helps regulate cycles.

Pregnancy Complications

In some cases, clots and bleeding may be due to miscarriage or an ectopic pregnancy located outside the uterus. These require emergency medical care.

Blood Clotting Disorders

Problems with blood clotting factors can promote heavy flow with large clots. Blood tests help diagnose clotting disorders like von Willebrand Disease.

Medications

Certain medication like blood thinners, antidepressants, and NSAIDs may cause menstrual changes including heavier bleeding and clots.

Always consult your OB-GYN for an exam if substantial clotting occurs for multiple cycles. Underlying problems are very treatable with medication, hormone therapy, or minor surgery.

When to Visit the ER for Period Clots

While small clots are usually normal, some extreme period symptoms constitute an emergency. Seek immediate medical treatment if you have:

Clots Larger Than a Golf Ball

Passing such large clots indicates severe bleeding needing prompt care. Large clots can completely fill the vagina and cause frightening symptoms.

Bleeding Through a Pad or Tampon Every Hour

If you must change feminine hygiene products hourly due to gushing blood, you could be hemorrhaging. This level of blood loss can lead to dangerous anemia.

Heavy Bleeding for Two Weeks Straight

Normally periods last 3-5 days. Bleeding longer than 10-14 days signals an urgent problem requiring treatment.

Severe Menstrual Pain and Dizziness

Clotting accompanied by cold sweats, nausea, weakness and pelvic pain may indicate ruptured ovarian cysts or another acute condition.

Don't hesitate to go to the ER or call 911 if you experience these red flag symptoms. You may need IV fluids, iron supplements, urgent gynecological surgery, or blood transfusions.

Emergency Treatment Options for Heavy Period Clotting

In the ER, you'll be assessed for:

• Vital signs like blood pressure, pulse, and temperature
• Pallor, cold skin indicating anemia
• Abdominal exam to check for rigidness or tenderness
• Pelvic exam to locate any masses or trauma
• Pregnancy test, urinalysis, and bloodwork

Based on results, emergency interventions may include:

• IV fluids and iron supplements
• Oxygen, if anemic
• Blood transfusion for severe blood loss
• Emergency D&C procedure to scrape the uterine lining
• Medications to control bleeding
• Surgery to remedy ruptured cysts/tumors and stop bleeding

The OB-GYN specialists in the ER will act quickly to stabilize your condition, replace lost blood, and treat any underlying condition prompting hemorrhaging.

When to Follow Up After an ER Visit for Clotting

It's crucial to follow up with your own OB-GYN within a few days of emergency treatment for heavy period clotting. Your OB-GYN can:

• Review ER test results
• Perform any additional necessary exams
• Prescribe medication to prevent future heavy bleeding
• Refer you to specialists like gynecologic oncologists or hematologists
• Schedule any needed ultrasounds, biopsies, or surgeries

Don't skip this vital follow-up care. Undiagnosed conditions causing severe blood clotting could quickly recur and lead to dangerous bleeding or long-term reproductive health consequences.

When Medications Reduce Heavy Period Clotting

If hormonal or clotting disorders underlie constant heavy clots, medications often help regulate your cycles and lighten flow. Options may include:

Birth Control Pills

Oral contraceptives that contain estrogen and progestin help stabilize hormone fluctuations, often decreasing bleeding and clotting.

NSAIDs

Non-steroidal anti-inflammatory drugs like ibuprofen reduce period pain and prostaglandins that increase menstrual flow.

Antifibrinolytic Drugs

Medications like tranexamic acid promote blood clot breakdown. This helps balance clotting and bleeding.

Gonadotropin-Releasing Hormone Agonists

GnRH agonists switch off estrogen production, stopping menstruation. This eliminates heavy bleeding and clotting.

Desmopressin

Desmopressin boosts low levels of von Willebrand factor, improving blood clotting ability. This reduces menstrual bleeding.

Your OB-GYN will determine if medication alone sufficiently resolves abnormal clotting, or if surgical procedures are also warranted.

When Surgery Treats Persistent Heavy Menstrual Clotting

If medication fails to lighten heavy periods and clotting, your doctor may advise surgery. Surgical options consist of:

Endometrial Ablation

This procedure destroys the entire uterine lining to stop periods. With no endometrial tissue, there is no bleeding and clotting.

Uterine Artery Embolization

Blocking the uterine arteries reduces blood flow to fibroids, polyps, and adenomyosis. This minimizes menstrual bleeding.

Myomectomy

This operation removes just fibroids causing heavy bleeding. It preserves fertility unlike hysterectomy.

Hysterectomy

Surgically removing the uterus provides a permanent fix for abnormal bleeding and clots. It ends fertility.

Talk to your gynecologist about risks and benefits of these surgical options for your situation. Removing or destroying problematic uterine tissue offers lasting relief from severe clotting.

When Home Remedies Soothe Period Clot Symptoms

For mild to moderate clotting between doctor’s visits, home remedies can provide comfort. Consider trying:

Heat

Heating pads and hot water bottles relax pelvic muscles. Heat also boosts circulation to ease cramps.

OTC Pain Relievers

Medications like ibuprofen, aspirin, and acetaminophen reduce prostaglandin release. This diminishes uterine spasms and cramping.

Exercise

Light physical activity releases endorphins to ease discomfort. But avoid exhausting workouts that could worsen bleeding.

Healthy Diet

Eating anti-inflammatory foods like turmeric, ginger, berries and leafy greens may lessen period symptoms.

Stay Hydrated

Drinking plenty of water prevents dehydration and thins menstrual blood for lighter flow.

While these DIY tips can't treat an underlying condition, they may provide temporary relief as you seek medical care for persistent heavy clots.

When Lifestyle Changes Lessen Clotting

Your daily habits and exposures have a big impact on menstrual health. Try making these lifestyle adjustments to curb clotting:

Reach/Maintain a Healthy Weight

Being significantly over- or underweight alters estrogen levels. This negatively affects menstrual flow.

Quit Smoking

Smoking thickens blood and decreases estrogen. Both changes promote more clotting.

Lower Stress

High psychological stress increases prostaglandin production, enhancing uterine contractions and bleeding.

Limit Alcohol

Heavy, regular alcohol use is linked to elevated estrogen and heavier periods with more clotting.

Increase Exercise

Regular moderate aerobic exercise helps regulate menstrual cycles and maintain healthy hormone levels.

Supporting your overall wellness makes a big difference in promoting normal menstruation and avoiding problematic clotting.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.