During your period, do you notice thick, jelly-like clumps or globs of blood? These are called menstrual blood clots. Naturally, some women may worry that they may indicate an underlying health condition they need to address. Here’s what you need to know about menstrual blood clots.

Generally, having menstrual blood clots is normal

If you occasionally see blood clots during your period, don’t panic; in most cases, they are nothing to worry about.

To explain how period clots form, let’s look into the following concepts:

• During menstruation, hormones “command” your body to shed the endometrium or the lining of the uterus (womb).
• As the uterine lining sheds off, the vessels bleed. The blood and endometrial tissues pool in your uterus, waiting to be expelled.
• It’s normal for the blood and tissues to clump together, so the body makes anticoagulants, which prevent clotting. These anticoagulants break the clumps loose, allowing them to pass through the cervix more easily.
• However, there are instances when the passage of blood and tissues is faster than the production of the anticoagulants, resulting in menstrual blood clots.

Coagulation or clumping is helpful as it prevents too much bleeding. But, the question is, how do you know when these clots already signal an underlying health problem?

Menstrual blood clots: Red flags to watch out for

Period clots are generally normal so long as they happen occasionally, typically towards the beginning or end of your menstruation, are small, and are deep to bright red in color.

Now, if you notice that you frequently have menstrual blood clots, especially if they are large, about the size of a 5-peso coin or larger, it’s best to set an appointment with your doctor.

Passing large clots indicates heavy bleeding. Another indicator of heavy menstrual bleeding is when you need to change your tampons or sanitary pad after less than two hours.

The other red flags to watch out for include:

• Anemia
• Easy bruising
• Bleeding through your clothes or finding blood on your bedsheets.
• Significant pain

Possible causes of having menstrual blood clots

The most common reasons for menstrual clots or heavy bleeding, in general, are hormonal or structural problems, which may include:

• Uterine Fibroids or Polyps: Growths in the uterus, like polyps and fibroids, may block the exit of blood and tissues, giving them more time to clump together.
• Endometriosis: Clotting and unusual bleeding may also happen if you have endometriosis, a condition where the tissues lining the uterus appear elsewhere such as in the ovaries or fallopian tubes.
• Enlarged Uterus: A larger than normal uterus allows for more space for the blood and tissues to pool, giving them more time to coagulate or clot. A woman may have an enlarged uterus after pregnancy or due to other conditions, such as uterine fibroids.
• Hormonal Imbalances: Conditions involving hormonal imbalances, such as thyroid issues, polycystic ovary syndrome (PCOS), and even menopause can lead to irregular endometrial shedding, causing menstrual blood clots and heavy periods.
• Bleeding disorders: Bleeding disorders can also influence menstrual flow, leading to heavy bleeding.
• Cancers: Although rare, cancers in the uterus and cervix may also result in menstrual blood clots and heavy periods.

Additionally, women who experience pregnancy loss or miscarriage can pass large clots. Note that pregnancy loss may happen before the woman discovers her pregnancy, leading her to think that she’s just having irregular menstruation.

The next steps

If you frequently see large menstrual blood clots and experience other unexplained symptoms, talk to your doctor as soon as possible. They will conduct a health interview and physical assessment and may order some tests, such as blood tests or pelvic ultrasound, to identify the root cause of the problem. From the results, they’ll recommend an appropriate treatment strategy.

Learn more about menstruation, here.