OB/GYNs Explain When You Should (and Shouldn’t) Worry About Period Blood Clots
This article was medically reviewed by Carolyn Swenson, M.D., an assistant professor of obstetrics and gynecology and member of the Prevention Medical Review Board.
Even though blood clots sound scary, they’re usually a good thing. When you experience an injury—say, you accidentally cut yourself—your blood cells and proteins in your body join forces to form a clot and prevent excessive bleeding.
But those jelly-like blobs that appear during your period are a bit different than other types of blood clots. They include a mix of “various kinds of tissue products like coagulated blood, dead cells, and the top layer of the endometrium of the uterus—the lining,” says Adeeti Gupta, M.D., founder of Walk In GYN Care.
And while blood clots during your period can be a totally natural part of the process, they’re often a sign of a heavy flow, which can sometimes point to certain health problems. So, what exactly is going on in your uterus? Here, gynecologists to explain when you should (and shouldn’t) worry about menstrual clots.
Are blood clots normal during your period?
Most of the time, blood clots are simply just a part of menstruation. “A usual cycle is anywhere between 21 and 45 days and can change potentially on a monthly basis,” explains Carrie Coleman, M.D., a clinical instructor in the Massachusetts General Hospital Department of Obstetrics & Gynecology. “A usual flow may last anywhere from three to five to up to seven days and it may start off light, get heavy, and slowly resolve.”
Small blood clots—say, dime- or nickel-sized on your heaviest flow days—may appear during menstruation and that’s not uncommon, especially if you feel fine otherwise and you’re not experiencing any other unusual symptoms during your period. It’s also typical for the color of these clots to vary from light to dark shades of red.
When should you worry about blood clots during your period?
Menstrual bleeding that lasts more than seven days, known as menorrhagia, can be a signal of a larger health issue. If your clots are accompanied with any of the following symptoms, you should reach out to your gynecologist:
New blood clots that haven’t appeared in the past
Blood clots larger than a quarter
Bleeding for more than seven to 10 days
Heavy bleeding that requires you to change your pad/tampon every hour
Consistent spotting in the middle of your menstrual cycle
Excessive pain or cramping
What are the potential causes of large blood clots during your period?
If you are experiencing unusually large blood clots during your period, don’t freak out. It doesn’t always mean there’s something wrong, and every woman has her own version of “normal.” However, there are certain conditions that large blood clots and a heavier flow during your period can point to, including:
Uterine fibroids: These noncancerous growths of the uterus may form during your reproductive years. They don’t always cause symptoms, but can lead to heavy bleeding, long periods, and pelvic pain.
Endometriosis: This condition occurs when the tissue that lines the inner portion of your uterus (the endometrium) grows outside of the uterus, often spreading to other pelvic organs. Endometriosis can cause painful periods, painful sex, heavy bleeding, and even infertility.
Adenomyosis: This condition occurs when the endometrial tissue grows into the muscular walls of the uterus, resulting in longer, heavier periods, severe cramping, or pelvic pain.
Uterine polyps: These growths—caused by an overgrowth of the endometrium—attach to the inner wall of the uterus, reaching into the uterine cavity, which can cause irregular or heavy bleeding. They are typically benign, but can become cancerous.
Polycystic ovary syndrome: PCOS is a hormonal disorder characterized by high levels of androgens (male hormones), sometimes leading to the development of small cysts in the ovaries. This can cause irregular periods, as well as thinning hair, acne, and weight gain.
Ovarian cysts: Ovarian cysts are sacs filled with fluid or tissue on the ovaries. Most cysts are benign but some can be cancerous. If an ovarian cyst ruptures, it can cause bleeding and blood clots. Ovarian cysts can also cause irregular periods and heavy, painful menstruation.
Other hormonal imbalances: Hypothyroidism, perimenopause, and menopause can all cause fluctuations in your menstrual cycle and result in clots.
Miscarriage: “A woman may experience blood clots if she is miscarrying as well,” says Dr. Gupta. This can occur before you even realize you’re pregnant.
Cancer: In some cases, blood clots during your period can be a sign of uterine or cervical cancer, but this is very rare.
⚠️ If you suddenly experience dizziness or weakness with the clotting, head to an urgent care facility.
How to prevent blood clots during your period
Hormonal birth control can help keep your period in check, says Dr. Coleman, but if you’d rather not use hormonal contraception or are trying to conceive, taking ibuprofen up to three times a day on your heaviest days can reduce your flow and ease cramping.
“A healthy diet and lifestyle can actually help balance out hormones and excessive bleeding that is related to hormonal changes,” says Dr. Gupta. “However, if bleeding is due to actual anatomical problems such as fibroids, then those will need to be addressed.”
Your best bet? See your OB/GYN if you think the blood clots during your period may be pointing to something more serious. He or she can help provide an individualized treatment plan for you.
The bottom line: Your menstrual cycle can tell you a lot about your health.
Thankfully, period tracking apps make it a cinch to stay on top of your cycle length as well as symptoms like cramping, headaches, and flow intensity. Get to know your body and find a gynecologist you feel comfortable seeing if issues arise.
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