What causes large lumps of blood during periods?

Hello,

Welcome to icliniq.com.

I understand your concern.

Summary of your current symptoms:

1. Heavy bleeding with large clots.

2. Lower abdominal cramps (dysmenorrhea) and backache.

3. Bleeding that stopped and resumed (intermittent).

4. History of irregular cycles.

5. No medications or recent medical evaluations.

Possible explanations:

1. Hormonal imbalance or anovulatory cycles: With irregular cycles, it is common to skip ovulation, which can cause a thicker uterine lining to build up, leading to heavy, clot-filled periods when it sheds. The stop-start bleeding pattern is also common in such cycles.

2. Effect of emergency contraception: Since you took a morning-after pill in mid-cycle, it likely disrupted your hormone levels, causing an unusual or heavier-than-normal period.

3. Endometrial shedding with clots: Clots are common if the blood pools before exiting the uterus. Large clots (more than 0.98 inches) that repeatedly appear, especially with pain, can point to hormonal disorders, fibroids, adenomyosis, and PCOS (polycystic ovary syndrome).

4. Pregnancy-related issues: If there is any chance of pregnancy (even with the morning-after pill), you must rule out miscarriage or ectopic pregnancy. Heavy bleeding with clots and pain can sometimes be an early miscarriage. A pregnancy test is urgent if there is any uncertainty.

What to do now?

1. Immediate steps: Track your bleeding, note how many pads or tampons per hour, and the size of clots.

2. Take a pregnancy test as soon as possible.

3. Stay hydrated, rest, and apply a hot pack to the abdomen for cramps.

See a doctor if:

1. Clots are larger than a quarter (0.98 inches) and frequent.

2. You soak more than one pad per hour for two hours or more.

3. Pain is severe or radiates to one side.

4. Bleeding lasts more than seven days.

5. You feel dizzy, weak, or faint (a sign of anemia or excessive blood loss).

Longer-term next steps:

1. You should have a pelvic ultrasound to rule out fibroids, polyps, or ovarian cysts.

2. Consider hormonal blood tests such as FSH (follicle-stimulating hormone), LH (luteinizing hormone), estradiol, prolactin, and thyroid to assess for PCOS or imbalance.

3. Track your cycle and symptoms over the next few months.

I hope this has helped you.

Please feel free to reach out to me again if you have further queries.

Thank you.