Blood Clots During Period

Are blood clots during menstruation normal?

Menstrual cycles vary among women in length, flow, and frequency. While seeing blood clots during menstruation may be concerning, most clots are normal and result from the natural coagulation process during heavy blood flow, particularly in the first few days of the period.

However, if you notice large blood clots or significant changes in your period, it could be a sign to consult a doctor. Large or painful clots might indicate conditions such as uterine fibroids, adenomyosis, or endometriosis.

If you experience unusually large clots or severe pain during your period, it is advisable to seek medical advice for further evaluation and guidance.

What are the causes of heavy menses with blood clots?

Numerous conditions can cause someone to have unusually big blood clots or heavier menstrual flow than the norm. Some medical conditions include:

• Uterine fibroids: Fibroids are noncancerous growths in the uterus that can cause heavy menstrual bleeding and clotting, along with pelvic pain and pressure.
• Endometriosis: Endometriosis is a condition in which tissue that lines the inside of the uterus grows outside the uterus. This can cause heavy bleeding during periods, along with clotting and pelvic pain.
• Adenomyosis: Adenomyosis happens when the tissue that normally lines the uterus (endometrial tissue) grows into the muscular wall of the uterus, leading to heavy periods, clotting, and often severe menstrual cramps.
• Polycystic Ovary Syndrome (PCOS): PCOS is a hormonal disorder characterised by irregular periods, often with heavy bleeding.
• Hormonal imbalance: A hormonal imbalance occurs when you have too much or too little of one or more hormones. Fluctuations in hormone levels, particularly estrogen and progesterone, can affect the thickness of the uterine lining and the regularity of menstrual bleeding.
• Blood disorders: Certain blood disorders, such as von Willebrand disease or thrombocytopenia, can impair the blood’s ability to clot properly, leading to heavier menstrual bleeding and clots.

When to see the doctor?

If you find yourself needing to change your tampon or pad in less than two hours or pass clots the size of a quarter or larger, you should consult a doctor. 

What are the treatments available?

Treatment for heavy menses with blood clots depends on the underlying cause and severity of the symptoms. These include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter NSAIDs like ibuprofen or naproxen can help reduce menstrual cramps and decrease blood flow, which may also help with clotting.
• Tranexamic acid: This helps reduce heavy menstrual bleeding by promoting blood clotting. It is taken during menstruation and can help decrease the amount of blood loss and clotting.
• Hormonal birth control: Hormonal birth control methods, such as birth control pills, patches, or hormonal IUDs, can help regulate menstrual cycles and reduce heavy bleeding and clotting for some individuals. They work by stabilising hormone levels and thinning the uterine lining.
• Lifestyle changes: Certain lifestyle changes may also help manage heavy menstrual bleeding and clotting, such as maintaining a healthy weight, regular exercise, managing stress, and avoiding smoking.
• Treatment of underlying conditions: If heavy and clotted menstrual bleeding is due to conditions like fibroids, adenomyosis, endometriosis, or thyroid disorders, addressing the underlying condition with medication or other interventions may help alleviate symptoms.
• Iron supplements: Heavy menstrual bleeding can sometimes lead to iron deficiency anaemia due to blood loss. Taking iron supplements can help prevent or treat anaemia associated with heavy periods.
• Surgery: In some cases, surgery may be necessary to address underlying conditions causing heavy and clotted menstrual bleeding. For example, endometrial ablation, hysterectomy or myomectomy.

Make an appointment at Pantai Hospitals

It is crucial to be open and honest with your doctor about your symptoms to ensure you receive the right diagnosis and treatment. Your doctor is there to support you and provide the care you need.

Get in touch with us to book an appointment with our team of gynaecologists today, or find out more about our Obstetrics and Gynaecology Services at your nearest Pantai Hospital.

Pantai Hospitals have been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.