Passing Blood Clots? Here’s What It Means If You’re Not on Your Period

Most people with a uterus have a monthly menstrual cycle where they pass blood and clots for an average of five to seven days of time. However, some can have irregular periods, and it is not uncommon for people with a uterus to pass blood clots outside of their monthly cycle.

These blood clots are generally not a cause for concern unless they are larger than a quarter. If you are passing blood clots like this and are not on your period, it may be time to contact a healthcare professional.

This article provides more information on the causes and risks of abnormal blood clotting, along with the diagnosis and treatment.

many new clean tampons and one used bloody tampon

Axel Bueckert / Getty Images

Blood Clots: What Is and Isn’t Normal

It’s perfectly normal to notice some clots during your period. Menstrual clots are composed of blood mixed with the endometrial lining that builds up in your uterus in preparation for pregnancy. This sheds during your period when you don’t conceive.

Period clots generally occur when the menstrual flow is heavy. They are more common during the first two days of menstruation, which is typically the heaviest part of a period.

Clots can vary in color from bright to a darker, deep red. Menstrual blood begins to appear darker and more brown toward the end of each period as the blood is older and leaving the body less quickly.

For those with heavier flows, excessive bleeding and clot formation can last longer than normal. One-third of people with a uterus have periods so heavy that they soak through a pad or tampon every hour for several hours.

If the clots are small—no larger than a quarter—and only occasional, they’re usually nothing to worry about. Keep in mind that period clots are not life threatening, unlike some blood clots formed in your veins.

Spotting between periods is not uncommon, but regularly passing large clots between periods could signal a medical condition that needs investigation.

Normal clots:

  • Are smaller than one inch
  • Occur occasionally, usually around the beginning of your period

Abnormal blood clots:

  • Are larger than a quarter
  • Occur frequently

What Is Considered Heavy Menstrual Bleeding?

Speak to a healthcare professional if you have heavy menstrual bleeding between periods or you have clots larger than a quarter. Menstrual bleeding is considered heavy if you change your tampon or menstrual pad every two hours or less for several hours.

Causes of Abnormal Clotting

Physical and hormonal factors can impact your menstrual cycle and create a heavy flow. Heavy flows increase your chances of menstrual clots.

Some causes of abnormal uterine bleeding (such as bleeding and clotting between periods) include:

  • Uterine fibroids: These are noncancerous growths that develop in or around the womb and can cause heavy or painful periods.
  • Endometriosis: In this condition, the tissue that lines the womb (endometrium) is found outside the womb, such as in the ovaries and fallopian tubes.
  • Adenomyosis: This is a condition in which the endometrial tissue in your uterine lining breaks through and begins to grow in your uterine wall.
  • Hormonal imbalances: Hypothyroidismpolycystic ovary syndrome (PCOS), perimenopause, and menopause can cause irregular shedding of the uterine lining, resulting in clotting and heavy bleeding.
  • Miscarriage: Pregnancy loss can happen very early, sometimes before you even know that you’re pregnant. Clotting and bleeding are common symptoms.
  • Cancer in your uterus or cervix: This is a potential but less likely source of blood clots.
  • Bleeding disorders: Disorders such as platelet function disorder or von Willebrand’s disease may cause abnormally heavy menstruation.
  • Uterine or cervical polyps: These are growths on the cervical canal or uterus.
  • Precancerous changes in the uterus: This doesn’t mean that you have cancer.

The Risks of Passing Blood Clots

Prolonged heavy menstrual bleeding is a common cause of anemia in people with a uterus of reproductive age. In fact, one study found that 63.4% of those who experienced heavy periods also had anemia.

Symptoms include:

  • Fatigue
  • Weakness
  • Pale skin
  • Shortness of breath
  • Chest pains

Speak to a healthcare provider if you are experiencing the symptoms of anemia as a result of heavy menstrual bleeding.

Diagnosis

Your doctor may ask you questions about your medical history and menstrual cycles to find out what is causing your irregular clotting. You may be asked to keep a period diary, including notes on how heavy your flow was, if you had clots, and how much sanitary protection you needed to control it.

Next, your doctor will do a pelvic exam. They may also want to do some tests to figure out what might be causing your blood clots. These tests may include:

  • Blood test: This checks for anemia, problems with the thyroid, or problems with the way the blood clots.
  • Pap test: Cells are taken from your cervix and evaluated to see if any changes might be the cause of heavy bleeding and/or clots.
  • Endometrial biopsy: In this procedure, tissue samples of your uterine lining are removed and evaluated to look for abnormal cells.
  • Ultrasound: This painless procedure uses sound waves to monitor blood flow and check for fibroids or endometriosis in your uterus.

When to Call a Healthcare Professional

Call a healthcare professional if:

  • Your period lasts longer than eight days.
  • You bleed through one or more pads or tampons every one to two hours.
  • You feel dizzy, lightheaded, weak, or tired, or if you have chest pain or trouble breathing during or after your period. These can be symptoms of anemia. 
  • You pass menstrual blood clots larger than the size of quarters. (It is normal to pass clots the size of quarters or smaller.)

Treatment

The treatment for your menstrual clots will depend on the underlying cause and may include medication or surgery.

Medication

  • Heavy bleeding caused by problems with ovulation, endometriosis, PCOS, and fibroids often can be managed with certain hormonal birth control methods.
  • Hormone therapy can be helpful for heavy menstrual bleeding that occurs during perimenopause. 
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, also may help control heavy bleeding and relieve menstrual cramps. If you have a bleeding disorder, your treatment may include special medications to help your blood clot.
  • Tranexamic acid is a prescription medication that treats heavy menstrual bleeding. It comes in a tablet and is taken each month at the start of the menstrual period.

Surgery

Surgical treatment may be an option for you when you need to have polyps or fibroids removed. Your doctor may also recommend surgery if medication hasn’t remedied the issue.

  • Uterine artery embolization (UAE) is used to treat fibroids. In UAE, the blood vessels to the uterus are blocked, which stops the blood flow that allows fibroids to grow.
  • Myomectomy is surgery to remove uterine fibroids without removing the uterus.
  • Hysteroscopy can be used to remove fibroids or stop bleeding caused by fibroids in some cases.
  • Endometrial ablation destroys the lining of the uterus. It stops or reduces menstrual bleeding. Endometrial ablation should be considered only after medication or other therapies have not worked.
  • Hysterectomy is the surgical removal of the uterus. Hysterectomy is used to treat fibroids and adenomyosis when other types of treatment have failed or are not an option. It also is used to treat endometrial cancer. After the uterus is removed, you will no longer have periods and can no longer get pregnant.

Frequently Asked Questions

Is it normal to have blood clots larger than a quarter while not on your period?

It is not normal to have blood clots larger than a quarter while not on your period. You should consult your doctor anytime you have large clots outside of your period. The cause of the bleeding could be serious and should be investigated. 

What do I do if I pass blood clots that are larger than golf balls or lemons?

A large clot, about the size of a golf ball or larger, is a cause for concern and you should make an appointment with your doctor immediately for a checkup.

Why am I passing jelly-like blood clots?

Jelly-like blood clots can appear during the heavier days of your period and are completely normal. Those jelly-like clots include a mix of tissue-like blood, dead cells, and the top layer of the endometrial lining.

A Word From Verywell

Menstrual clots are a normal part of reproductive life. They may look alarming, but small clots are normal and common. Even clots larger than a quarter aren’t concerning unless they happen regularly or not with your regular menstrual cycle.

If you regularly pass large clots when not on your period, speak to your doctor so they can identify the underlying cause. Your doctor can recommend an effective treatment to help control heavy bleeding and reduce clots.

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Article Sources
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