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Period blood clots
If you’ve ever had blood clots during your period, you’re not alone. It’s a totally normal thing that happens to some people who menstruate. While some folks don’t have any clots at all during their periods, others may pass blood clots that vary in size, frequency, and color during the cycle. It’s typically not something to worry about, but it’s always important to keep track of what’s going on in your body to note any changes.
Tell me more about these clots...what are they?
First, a quick refresher on what’s released during a period: During the menstrual cycle, your body is trying to prepare for pregnancy by thickening the lining of the uterus for a fertilized egg (1). If the egg doesn’t get fertilized and/or doesn’t implant, this lining sheds, which is commonly known as a period. While it may seem like it’s only blood that is being released it’s also fibrous tissue, aka the lining of the endometrium (1). FYI, the endometrium is just part of the lining of the uterus, which is actually composed of three different layers: the endometrium, the myometrium, and the serosa (2).
And if you wanna get ~sciencey~ about the uterus (and we know you do!), the endometrium is the inner layer of the lining, the myometrium is the thick and muscular middle layer of the upper uterus which is the part that expands and contracts during labor/pregnancy, and the serosa is the smooth outer layer that helps the uterus move freely through the pelvic cavity (2).
The clots that come out of the endometrium may look thick, blob-like, or stretchy (for some it looks jelly-like) and may range in color from bright red to dark brown. Usually, these clots are tissue matter (1). A lot of people who have periods experience some form of clotting, and small globs are generally nothing to worry about. However, for some people, heavy periods with clotting can signal a more serious health issue (see below), and for others, heavy bleeding can also be a nuisance. In 2011, The Journal of Family Practice estimated that between 10%-30% of people with uteruses will see a doctor about heavy bleeding during their periods (3). People who have heavy bleeding may experience frustration and it can affect some people’s’ mental health.
WHAT DO BLOOD CLOTS IN YOUR PERIOD MEAN?
If you have heavy periods, blood clots could mean that the blood matter (that also contains tissue) is being released too quickly for your body to break it down. Typically our bodies create something called “anticoagulants,” which help to thin the blood that is being released. Coagulation essentially means “clotting” and coagulants are protein substances in the body that create blood clotting (there have also been many studies that link vitamin K and coagulants)(4). However, some of the clots that happen during the period are due to the fact that the blood is released too fast for the anticoagulants to have a chance to break down the blood (5).
Sometimes people may have a really heavy flow on the first or second day of their period, and many people who are going through puberty may experience heavy bleeding for a year (5). However, having a day of really heavy flow—like soaking through a pad or a tampon in an hour for more than two hours, or frequently changing long-lasting sanitary products like a menstrual cup—may signal that it might be time to talk to a doctor or midwife. Heavy bleeding can be caused by a few different things, such as (6):
- Hormone imbalance, like polycystic ovary syndrome (PCOS) or endometriosis
- Uterine fibroids
- Dysfunction of the ovaries
- A copper IUD, such as Paragard
- Bleeding disorders
Very heavy periods with clotting can also leave people at risk for anemia, which can make people feel fatigued, weak, and in severe pain (6). If you’re experiencing extremely heavy periods with clotting it is important to take note of what happens during your period and to talk to a doctor or midwife, especially if the bleeding is associated with pain. Remember, you don’t have to live in period pain!
It’s also important to make sure that you’re monitoring your periods and checking in with yourself (and then with a health care provider) if you notice any changes—especially if you’re experiencing easy bruising, fatigue, or pain. A medical professional will want to take down your medical history, to know what changes you have seen in your cycle, and will likely perform an exam and run some blood tests. Some medical professionals may perform an ultrasound to look inside the uterus and in the case that there is a cancer risk, or they may ask for a biopsy (7).
Large blood clots during period
So while the clots that are released during the period may change in color—they go from bright red to dark brown, similar to how your blood may change colors during your period (1)—one thing that you should pay attention to is your flow. Having a lot of blood clots in your period is typically related to heavy periods. Planned Parenthood recommends checking in with a medical professional if you frequently see clots larger than the size of a quarter.
If you don’t normally experience clottings and there’s a lot of blood all of a sudden, the heavy bleeding, combined with large blood clots during your period, could also be a sign of a miscarriage (8). This can happen in the early stages of pregnancy so you may not have even known you were pregnant.
Jelly like blood clots during period
As we age, our cycles change. Of course, we know many people with a uterus may experience menopause around age 50 (or earlier or later!) (9). Before people start menopause there is a sort of in-between stage known as perimenopause (10). People in perimenopause may experience more clotting than they have previously, and particularly jelly-like clotting. Many doctors believe this is because during perimenopause the reproductive hormones progestin and estrogen are fluctuating more than they have been before, and the shifts in estrogen may create jelly-like clots (11).
Is there anything I should do about these clots?
Nope! Small blood clots are typically not a big deal. However, if you find that you have extremely heavy bleeding associated with pain or fatigue you should speak to a medical provider to see if there are any underlying health issues that need to be addressed.
A lot of people experience blood clots during their period, and typically it’s just part of a healthy period. However, if you notice big changes or the clots are increasingly heavy—so heavy they interfere with your daily life—check in with a medical professional.
Written by: Moriah Engelberg, health education enthusiast.
Medically reviewed by: Aisha Williams, RN
All content found on this Website, including: text, images, audio, or other formats, was created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
(1) Planned Parenthood. N.D. “Menstruation.” Planned Parenthood. https://www.plannedparenthood.org/learn/health-and-wellness/menstruation
(2) University of Rochester Medical Center. N.D. “The Anatomy of the Uterus.” University of Rochester Medical Center. https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=34&contentid=17114-1
(3) Levy, Robert; Prasad, Shailendra and Rowland, Kate. 2011. The Journal of Family Practice 60 no.7:410 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3183964/pdf/JFP-60-410.pdf
(4) Palta, Anshu; Palta, Sanjeev and Saroa Richa. 2014. “Overview of the Coagulation System.” Indian Journal of Anesthesia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4260295/
(5) The Center for Young Women’s Health (CYWH). 2018. “Menstrual Periods.” A collaboration between the Division of Adolescent and Young Adult Medicine and the Division of Gynecology at Boston Children’s Hospital. https://youngwomenshealth.org/2010/04/21/menstrual-periods/
(6) The Mayo Clinic. 7 July 2015. “Menorrhagia (heavy menstrual bleeding).” The Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/menorrhagia/symptoms-causes/syc-20352829
(7) Wehn, Danielle. 30 October 2018. “Menstrual Clots During Heavy Periods: What’s Normal & What’s Not?” Cleveland Health Clinic. https://health.clevelandclinic.org/menstrual-clots-during-heavy-periods-whats-normal-whats-not/
(8) Baird, Donna; Hartmann, Katherine, Hasan, Reem; Herring, Amyh; Jonsson Funk, Michele L.; Olshan, Andrew. 2010. “Association Between First-Trimester Vaginal Bleeding and MIscarriage.” Obstetrics and Gynecology 144, no.4(Fall): 860. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2828396/
(9) The Mayo Clinic. 7 August 2017. “Menopause.” The Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397
(10) The Mayo Clinic. 7 May 2019. “Perimenopause.” The Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666
(11) Baylor College of Medicine. N.D. “Menopause.” Baylor College of Medicine: Sexuality and Reproductive Health. https://www.bcm.edu/research/centers/research-on-women-with-disabilities/topics/sexuality-and-reproductive-health/menopause