Periods can bring a lot of uncomfortable symptoms and some of them may even end up worrying you. Blood clots may be one such cause for worry. You have probably seen globs of blood come out as you pee. Or, you may have noticed them inside your menstrual cup or on your pad.
But, before we get into understanding if they’re normal, let’s find out what blood clots really are.
What are blood clots and when do they happen?
Hormones in your body trigger the lining of your uterus to begin shedding during menstruation, and tiny blood vessels rupture as a result. Plasma and platelets help produce blood clots, which range in colour from bright to dark red, to keep your body from losing too much blood.
One month, you may have a heavier flow with menstrual clots may occur, followed by a lesser flow with no clots the next month, which is normal and may occur as a result of changes in your diet and lifestyle.
Are blood clots during a period normal?
It really depends on the situation. If the clots are about the size of a quarter and only happen once in a while, they're typically not a cause for concern. Menstrual clots, unlike clots that grow in your veins, are not harmful on their own.
The uterine lining sheds and collects at the uterus's bottom, where it waits for the cervix to contract and release its contents. Anticoagulants are released by the body to help in the breakdown of hardened blood and tissue, allowing it to pass more easily. Menstrual clots are formed when blood flow exceeds the body's ability to manufacture anticoagulants.
This type of blood clot is more prevalent on days when there is a lot of blood flow. Heavy flow days are common at the start of a period for many women, but they usually don't last beyond a day or two. Menstrual bleeding that lasts 4-5 days and generates 2-3 tablespoons of blood or less is considered to be normal, but your normal can vary from the standard as each person is unique.
When should you be concerned?
If you notice clots much larger than a quarter (say, the size of a golf ball) and you pass them frequently every couple of hours, you should be concerned. You should also keep an eye out for heavy bleeding, where you’re soaking through a pad or tampon every two hours in a row.
If significant bleeding occurs just once during a cycle and is not repeated, it is usually not a cause for concern. But, you must examine the pattern of how often it occurs and how long it lasts in case it keeps repeating.
Also, if you're passing clots and suspect you're pregnant, seek medical care at once. You might be experiencing a miscarriage or an ectopic pregnancy, which can prove to be fatal.
What causes abnormal blood clots?
Physical and hormonal factors might alter your menstrual cycle and cause a strong flow, which raises your risks of clotting. There may be an underlying condition that is making your flow abnormally heavy, as a result of which big and frequent blood clots are happening:
- Fibroids - Fibroids are muscular tumours that form in the uterine wall and are usually noncancerous, causing irregular menstrual bleeding, abnormal clots, fertility issues and painful menstruation, among other things.
- Obstructions in the uterus - Conditions that cause the uterus to expand or engorge might place additional strain on the uterine wall, and heavy menstrual bleeding and clots may become more common as a result of this. They can also make it difficult for the uterus to contract, causing blood to pool and coagulate inside the uterine cavity's well, eventually forming clots that pass through your vagina.
- Hormonal imbalances - The uterine lining requires a balance of estrogen and progesterone to develop and thicken appropriately. You might have excessive or irregular menstrual bleeding with atypical clots if you have too much or too little of one or the other hormone.
- Adenomyosis - Adenomyosis occurs when the uterine lining develops into the uterine wall for unexplained causes, prompting the uterus to expand and thicken. This frequent disorder can cause the womb to swell two to three times its normal size, in addition to persistent, heavy bleeding with clots.
- Thyroid issues - Thyroid gland disorders can result in improper thyroid function and affect your periods. If left untreated, you may suffer from irregular menstrual bleeding and abnormal blood clots during your menses.
- Endometriosis - Endometriosis is a disorder in which endometrial cells, which look like the uterine lining, develop outside the uterus and into the reproductive canal on your ovaries or fallopian tubes, among other places. It can cause irregular bleeding around the time of your monthly cycle, which may or may not include clotting, as well as other symptoms such as severe cramps, nausea, and painful intercourse.
- A miscarriage - Depending on the stage of the pregnancy, a person will end up passing a number of big clots in case a miscarriage (pregnancy loss) occurs. Because the miscarriage can often happen before a woman even realises she is pregnant, she may mistake an early miscarriage for a typical menstrual cycle.
- Cancer - Cancerous tumours of the uterus and cervix can sometimes cause severe monthly bleeding and big blood clots, though it's rare.
When should you see a doctor?
Blood clots are a common occurrence in the female reproductive system, and, even bigger clots, while scary, aren't a reason for concern unless they occur on a regular basis.
If you have big blood clots on a frequent basis, periods of significant blood loss, or any other concerning symptoms, see your doctor for an accurate diagnosis and appropriate treatment.
Based on your symptoms, the doctor may advise you to:
- Try hormonal contraceptives to reduce bleeding and correct hormonal imbalances
- Adopt a healthy diet that includes iron-rich food like meat and dark green leafy vegetables
- Stay hydrated to maintain your body’s fluid levels
- Opt for other medications or surgery