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Menstrual discharge does not always have a uniform consistency. Small blood clots during periods can be a normal variant, but sometimes they indicate a gynecological disease. It is most important to pay attention if clots are accompanied by very heavy bleeding, severe pain, weakness, or recur during almost every cycle.

In this article, we will explain why periods come with clots, in which cases this is a physiological feature, and when it requires a consultation with a gynecologist. We will also look at what clots may look like, which symptoms are alarming, and when it is worth seeing a doctor.

Why blood clots come out during periods

During menstruation, particles of the endometrium — the mucous membrane that grows every month — come out of the uterine cavity together with blood. If menstrual blood remains in the uterine cavity or vagina even for a short time, it has time to partially clot. This is why clots can appear during menstruation. According to American College of Obstetricians and Gynecologists (ACOG), heavy menstruation with clots can be both a normal variant and a manifestation of diseases that require examination.

Small clots, especially in the first one or two days of menstruation, are often a physiological phenomenon. At the same time, periods with clots can also occur with some gynecological diseases or hormonal disorders.

The most common causes of clots are:

  • individual characteristics of menstruation;
  • heavy menstrual bleeding;
  • uterine fibroids;
  • endometrial polyps;
  • endometriosis;
  • hormonal disorders;
  • recovery after childbirth or miscarriage.

Doctors at «Oxford Medical» recommend not ignoring changes in the nature of menstruation. If many clots appear during periods, bleeding has significantly increased, or severe pain has appeared, it is worth undergoing a gynecological examination to determine the cause and, if necessary, start treatment in time.

What clots during periods look like and what they mean

What clots during periods look like and what they mean

During menstruation, clots can differ in size, shape, and shade. Their appearance alone does not make it possible to establish a diagnosis, but in combination with other symptoms it can help suspect a certain disorder. Not only the appearance of the clots is important, but also the amount of blood loss, duration of menstruation, presence of pain, and regularity of the cycle.

Blood clots during periods look like liver — should you worry

Many women describe blood clots during periods as fragments that look like liver. In fact, this is not tissue from internal organs, but clotted blood together with particles of the endometrium. If such clots appear rarely, are small in size, and are not accompanied by severe pain or heavy bleeding, this may be a normal variant.

If such clots appear during almost every menstruation, become larger, or are combined with other symptoms, it is necessary to undergo an examination to rule out uterine diseases.

Large blood clots during periods

A single large blood clot during periods does not always indicate pathology. It can form if blood has remained in the uterine cavity or vagina for some time and has had time to clot.

Regular appearance of large clots, especially together with heavy menstruation, pain, or weakness, may be associated with uterine fibroids, endometrial polyps, adenomyosis, or other gynecological diseases. In this case, the doctor may recommend transvaginal ultrasound to assess the condition of the uterus and endometrium.

Dark blood clots during periods

A dark or almost burgundy shade most often means that blood stayed in the uterine cavity a little longer and had time to oxidize. Therefore, dark clots during periods are not a dangerous symptom by themselves.

A reason for consultation with a gynecologist is a situation when very thick periods are combined with an unpleasant odor of discharge, increased body temperature, severe pain, or appear for the first time after a long period of normal menstruation.

Very heavy periods with clots

Very heavy periods with clots may indicate excessive menstrual blood loss. If a pad or tampon becomes completely soaked in less than 1–2 hours for several hours in a row, and weakness, dizziness, or shortness of breath appears, it is not worth postponing a visit to the doctor.

When blood clots during periods are a reason to see a gynecologist

When blood clots during periods are a reason to see a gynecologist

If clots appear only occasionally, are small in size, and are not accompanied by other symptoms, in most cases they are not dangerous. However, a change in the nature of menstruation, especially if it repeats over several cycles, requires a consultation with a doctor.

Do not postpone a visit to a gynecologist if:

  • the clots are large or their number increases;
  • menstruation lasts more than 7 days;
  • a pad or tampon has to be changed more often than once every 1–2 hours;
  • bleeding is accompanied by severe pain, weakness, dizziness, or fainting;
  • clots appeared after a long delay in menstruation;
  • bloody discharge occurs between periods or after sexual intercourse.

Doctors at «Oxford Medical» recommend not waiting for symptoms to go away on their own. To determine the cause, the doctor may prescribe colposcopy of the cervix, ultrasound examination, blood tests, and, if indicated, Pipelle biopsy of the endometrium. The scope of examination is determined individually depending on the symptoms and the woman's age.

During the consultation, the gynecologist evaluates not only the nature of menstruation, but also other symptoms. For example, an irregular cycle, acne, or excessive hair growth may be signs of polycystic ovary syndrome and require additional examination.

What to do if periods come with clots

Periodic blood clots during periods are normal if they are small, appear only on certain days of the cycle, and are not accompanied by other complaints. If the nature of menstruation has changed, the clots have become large, and the bleeding has become heavier, these symptoms should not be ignored.

Until the diagnosis is established, it is advisable to:

  • monitor the amount of blood loss and how often pads or tampons are changed;
  • avoid excessive physical exertion if menstruation is very heavy;
  • maintain an adequate drinking regimen, since significant blood loss can worsen well-being;
  • not take hormonal or hemostatic medications without a doctor's prescription.

Further treatment depends on the cause. If the appearance of clots is associated with uterine fibroids, polyps, polycystic ovary syndrome, or other gynecological diseases, the tactics will differ. That is why it is important not to fight only the symptom, but to identify its cause and undergo treatment aimed at eliminating the underlying disease.

The information in the article is provided for informational purposes and is not an instruction for self-diagnosis and treatment. If symptoms of disease appear, you should consult a doctor.

Sources:

American College of Obstetricians and Gynecologists

National Institute for Health and Care Excellence

US National Library of Medicine