Introduction:
Every menstrual cycle is unique and can vary in frequency, length, and amount from person to person. Even though passing blood clots during the menstrual cycle is normal, for most people seeing menstrual blood clots can be a scary thing. Blood clots during a period are normal; however, noticing large blood clots and experiencing changes in periods should be checked with the doctor. The doctor may then check for the presence of any underlying problem which may be the cause of heavy periods.
What Are Period Clots?
Period clots are gel-like blobs of tissue, coagulated blood, and blood that are expelled from the uterus during menstruation. Blood clots are the body’s natural way of defense mechanism to prevent bleeding. The hormones in the body cause the uterus lining to start shedding during menstruation. This process leads to the bleeding of small blood vessels. To prevent heavy blood loss from the body, platelets and plasma function together to form blood clots. This is similar to the clotting action that takes place anywhere in the body in response to an injury like a laceration or cut. Even though blood clots during menstruation usually do not indicate a problem, sometimes they are considered a sign of a health condition.
When Do Period Clots Happen?
Usually, menstrual clots occur on days of heavy flow. Blood clots are typically seen during the first two days of the menstrual cycle, which are generally considered the heaviest part of a period. The consistency of blood during periods varies from one period to another and throughout the period. Sometimes people experience heavy flow with menstrual clots for one month, followed by a lighter flow without clots during the next month. These changes seen in the amount of blood flow and period clots are natural, as these variations are highly associated with lifestyle factors and diet.
What Are Normal and Abnormal Period Clots?
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Normal Period Clots:
Small clots that occur occasionally and are not larger than a quarter are considered normal period clots. These clots are dark or bright red and usually occur at the beginning of the menstrual cycle.
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Abnormal Period Clots:
Clots that occur frequently and are larger than a quarter in size are considered abnormal period clots. Heavy bleeding accompanied by large clots during periods is a medical condition that needs attention. Blood clots during pregnancy can be a sign of miscarriage. During menstruation, if a person changes the menstrual pad or tampons every two hours or less several times, it is considered heavy bleeding.
How Are Period Clots Formed?
Usually, women of childbearing age shed their uterine lining (endometrium) once every 28 to 35 days. Throughout the month, the endometrium grows and thickens in response to a female hormone, estrogen. The actual purpose of endometrial thickening is to support a fertilized egg. When pregnancy does not occur, the uterine lining begins to shed, which is known as menstruation or periods. The uterus lining, which has been shed, gets mixed up with blood, mucus, and tissue. This mixture is then released from the uterus through the cervix and out of the vagina. During this process, the body releases proteins which leads to the coagulation of blood in the uterus. This coagulation takes place to prevent the uterine lining from bleeding continuously. The blood already shed by the body also contains coagulation proteins. When the blood flow is substantial, coagulation proteins in the blood begin to clump together, resulting in the formation of menstrual clots. Menstrual clots are usually formed in the uterus or vagina when the menstrual blood pools before leaving the body.
What Are the Symptoms of Abnormal Period Clots?
Even though blood clots during periods are normal, the following symptoms may indicate the possibility of a medical issue. They are as follows:
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Clots larger than a quarter in size.
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Severe pain accompanied by clots.
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Frequent release of clots.
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Abnormal blood flow during periods that leads to changing pad or tampon once in two hours or less.
What Are the Conditions Leading To Abnormal Period Clots?
The common conditions leading to heavy blood flow or abnormal clots during periods are as follows:
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Uterine Fibroids or Polyps:
Uterine fibroids are non-cancerous tumors that grow both inside or outside the uterus. Uterine polyps are the growths seen on the inner lining of the uterus. Any obstructions in the uterus reduce its ability to force the blood out at a normal speed. This leads to the pooling of blood and the formation of clumps within the uterus leading to clot formation, which is later expelled out.
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Adenomyosis:
Adenomyosis is a condition in which the uterine lining grows into the uterine wall leading to enlargement and thickening of the uterus. This condition leads to heavy blood flow during periods with the presence of blood clots in the menstrual blood.
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Endometriosis:
Endometriosis is a condition in which tissues of the uterine lining grow outside the uterus into the reproductive tract. One of the significant features of this condition is heavy bleeding which may or may not include clots.
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Hormonal Imbalances:
The balance of hormones estrogen and progesterone is essential for maintaining a healthy uterus. An imbalance in hormone levels can lead to many issues, including heavy menstrual bleeding and clots.
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Cancer:
Cancers in the cervix or uterus can cause heavy menstrual bleeding.
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Miscarriages:
Miscarriages or early pregnancy loss can lead to heavy bleeding accompanied by a large number of clots.
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Bleeding Disorders:
Bleeding disorders can affect the coagulation proteins that are required for the uterine lining to stop bleeding. Hence disorders like von Willebrand’s disease or platelet function disorder can lead to heavy menstruation.
How to Diagnose Abnormal Blood Clots During Periods?
The following measures are carried out to diagnose abnormal clots during periods:
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The doctor may take a detailed history of the patient regarding the use of birth control, lost pregnancy, and previous pelvic surgeries, which can affect normal menstruation.
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Blood tests are done to check for hormonal imbalances.
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Imaging tests like magnetic resonance imaging (MRI) or ultrasound to detect endometriosis, fibroids, and other abnormalities.
How to Treat Abnormal Period Clots?
The treatment of abnormal period clots involves controlling heavy menstrual bleeding. The various treatment options are as follows:
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Medications:
Hormonal medications help in controlling heavy bleeding by balancing hormones. Nonsteroidal anti-inflammatory drugs (NSAIDs) help in reducing cramps, pain, and excessive bleeding. Birth control methods like the intrauterine device (IUD) containing progestin or certain birth control pills help in reducing abnormal menstrual bleeding, thereby preventing clots.
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Surgery:
A dilation and curettage (D and C) that involves widening the cervix followed by scraping of the uterine lining can give temporary relief for heavy bleeding. Women with uterine growths like fibroids may require surgery to remove the growth. Large growths are removed by myomectomy, while small growths can be removed by laparoscopic surgery. In some women, removal of the uterus (hysterectomy) may be advised.
Conclusion:
Period clots are a part of women’s reproductive life. Even though it looks alarming, it is a common phenomenon occurring in the life of every woman. However, bigger clots that occur frequently require immediate medical attention as it may be an indication of an underlying disease. Hence following an effective treatment plan under the guidance of a doctor would help in diagnosing the underlying condition and reducing the clots.
