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

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Most people with a uterus, or womb, have a monthly period where they pass blood and gel-like masses of blood, called clots, for an average of five to seven days. However, some can have irregular periods, and may pass blood clots outside of their monthly cycle.

Clean tampons surrounding a tampon with blood.

Axel Bueckert / Getty Images

This article explains what blood clots are and when they may be concerning. It will also cover the causes of abnormal clotting, how it's diagnosed, and treatment options.

What Does It Mean When You Pass Blood Clots?

It’s perfectly normal to notice some blood clots during your period. Also called menstrual clots, these are made up of blood and built up uterine tissue known as the endometrium. Clots can vary in color from bright red to a darker, deep red.

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

For those with heavier flows, excessive bleeding and clot formation can last longer than normal. About 33 percent of people with a uterus have periods so heavy that they soak through a pad or tampon every hour for several hours.

If period clots are small—no larger than a quarter—and only occasional, they’re usually nothing to worry about.

When Should I Be Worried About Blood Clots?

Spotting, which is when you bleed just a few drops of blood between periods, is not uncommon. However, regularly passing large clots between periods could be a sign of a medical condition that needs investigation.

Blood clots are considered abnormal if they are larger than a quarter and occur often. Speak to a healthcare professional if you bleed heavily between periods or you have clots larger than a quarter. Bleeding is considered heavy if you have to change your tampon or pad every two hours or less.

Recap

Light spotting between periods is considered typical. However, passing large clots or bleeding heavily between periods warrants a call to your doctor.

What Causes Abnormal Clotting?

Many factors and conditions can cause abnormal clotting including:

  • Uterine fibroids: These are noncancerous growths that develop in or around the uterus and can cause heavy or painful periods, as well as blood clots.
  • Endometriosis: In this condition, the endometrium is found outside the womb in other organs, such as in the ovaries. This can lead to irregular periods and blood clots.
  • Adenomyosis: This is a condition in which the endometrial tissue that normally lines the uterus breaks through and begins to grow into your uterine wall. This can lead to heavy periods and clots.
  • Hormonal imbalances: Perimenopause, which is the stage right before menopause, and menopause, which is diagnosed when your periods stop for at least a year, can cause irregular shedding of the uterine lining. This can result in clotting and heavy bleeding.
  • Medical Conditions: Hypothyroidism, which occurs when your thyroid doesn't make enough thyroid hormone, and polycystic ovary syndrome (PCOS), which is when multiple cysts grow on the ovaries, can lead to 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.
  • Uterine or cervical polyps: These are growths on the uterus or cervical canal, which connects the uterus to the vagina. These can lead to heavy bleeding and clots.

What Are the Risks of Passing Blood Clots?

Long-term heavy menstrual bleeding is a common cause of iron deficiency anemia, a condition where there aren't enough red blood cells in the body. In fact, one study found that about 63 percent of those who experienced heavy periods also had anemia.

Symptoms of anemia may include:

Speak to a healthcare provider if you are experiencing symptoms of anemia.

How Are Blood Clot Conditions Diagnosed?

Your doctor may ask you questions about your medical history and your period to find out what is causing your irregular clotting. You may be asked to keep a period diary to track the heaviness of your period, if you had clots, and how many period products, like pads or tampons, you used.

Next, your doctor may do a pelvic exam. They may also want to do some tests including:

  • Blood test: This may be used to check for hormonal and blood clot issues, as well as low iron levels.
  • Pap test: Your cervix is swabbed to get a sample of cells to see if any abnormal changes might be the cause of heavy bleeding and/or clots.
  • Endometrial biopsy: In this procedure, a sample of your uterine tissue is taken to check for abnormal cells.
  • Ultrasound: This procedure uses sound waves to check blood flow and to look for fibroids or endometriosis in your uterus.

Recap

To diagnose your condition, your doctor will take your medical history, give you a physical exam, and may also order specific tests to better understand what's going on.

How Are Blood Clots Treated?

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

Medication

Medication options may vary depending on the specific condition:

  • Hormonal birth control methods can often manage heavy bleeding caused by endometriosis, PCOS, and fibroids.
  • Hormone therapy can be helpful for heavy menstrual bleeding that occurs during perimenopause. This treatment reduces perimenopause symptoms by replacing the hormones that naturally stop being made during this time.
  • 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 your period.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil (ibuprofen), may help with heavy bleeding, including clots, and relieve period cramps.

Surgery

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

  • 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 that removes uterine fibroids without removing the uterus.
  • Hysteroscopy may be used to remove fibroids or stop bleeding caused by fibroids.
  • Endometrial ablation removes the lining of the uterus. It stops or reduces menstrual bleeding.
  • Hysterectomy is the surgical removal of the uterus. Hysterectomy is used to treat fibroids, adenomyosis, and endometrial cancer. After the uterus is removed, you will no longer have periods and can no longer get pregnant.

Summary

Passing small blood clots while on your period is nothing to worry about. However, frequently passing large clots that are larger than a quarter and bleeding heavily in between periods warrants a call to your doctor.

Abnormal clotting may be caused by hormonal imbalances, certain medical conditions, and some types of cancer.

To diagnose blood clot-related conditions, your doctor will take your medical history, give you a physical exam, and may also order specific tests.

Treatment for abnormal clotting may include medication and surgery.

Frequently Asked Questions

  • Is it normal to have golf ball sized blood clots?

    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.

  • 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. Jelly-like clots may include a mix of blood, dead cells, and the top layer of the endometrial lining.

  • Why am I experiencing a sudden gush of blood if I am not on my period?

    Abnormal vaginal bleeding may occur if you have perimenopause, fibroids, certain cancers, and hormone imbalance-related issues. A miscarriage or other pregnancy-related issues can also trigger this.

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