No matter how old you are, there’s a good chance you still have questions about your period. Even if you think you’ve got the intricacies of your cycle down pat, things can change on a dime, and suddenly you’re experiencing period symptoms you’ve never had before. If one of those things is the sudden appearance of jelly-like blood clots during your period, it’s understandable to be a little freaked out.
Every person’s cycle is unique, which means yours will vary in terms of length, amount of blood, and frequency with which it arrives — that’s without mentioning the many things that can cause your cycle to change, such as age, hormonal birth control, changes in your health, plus pregnancy and the postpartum period.
As you try to stay on top of all these changes, you might be wondering what’s “normal” when it comes to blood clots during your period. Maybe you see a clot that’s larger than you’ve ever noticed before, or maybe it’s a different color than you’re used to. Don’t panic, because an OB-GYN is here to answer all your period clotting questions.
What are blood clots, and why do they happen during your period?
First, a quick refresher on why you might notice blood clots during your menstrual cycle. When implantation does not occur — meaning you’re not pregnant — you’ll start your period. “During your period, the lining of the uterus sheds,” says Dr. Jill Purdie, OB-GYN and medical director at Pediatrix Medical Group. “This causes small blood vessels to break. The body naturally wants to heal by sending cells to the area to slow the bleeding by making it clot, just like when you have a cut. So, some blood clots during your period are normal.”
The body’s normal, natural attempt to heal is just one reason why you might notice clotting. “Blood clots also occur during menses when the menstrual blood collects in one place for too long and begins to solidify,” she adds, noting that “these clots typically occur when the menstrual blood flow is the heaviest” — i.e., the early part of your period — “and the blood collects in the lower part of the uterus or upper vagina.” You’ll likely notice this happen if you’ve been sitting or lying down for a long period of time, such as when you’re sleeping at night. When you get up again, you might notice clotting, says Purdie.
This may take the form of those jelly-like blood clots during your period, which, let’s be honest, is never a pleasant thing to discover. These are usually just a mix of blood and tissue released from your uterus, and you might notice different sizes or even colors. Most of the time, these clots are quote-unquote normal... but let’s discuss that a bit more in depth.
What’s considered “normal"?
As mentioned above, “normal” is different for everyone. But generally speaking, “In a normal menstrual cycle, the clots are typically bright red or dark red. Most of them will be dime- to quarter-sized,” says Purdie. “They may be more bright red in color at the beginning of the cycle and get darker as the cycle progresses. Blood clots are more likely to occur when the flow is the heaviest, which for most people is at the beginning of their menses.”
You might also notice some pain and cramping associated with passing these clots, says Purdie. “In order for the uterus to pass a blood clot, the cervix has to open, or dilate, enough to let the clot through. This often causes cramping until the clot passes.”
When should you see a doctor?
As with any period-related concerns, you should always check in with your doctor if any period symptom is interfering with your overall health and well-being or making it difficult to carry out your daily tasks. That said, “Clotting may be abnormal if this is a new occurrence for someone, meaning a change from their normal flow. It may also be abnormal if the clots are larger than quarter-sized. In addition, if someone is bleeding enough to change a saturated pad or tampon every hour for more than two hours, this could indicate an issue.”
Purdie recommends giving your OB-GYN a call if you’re passing clots that are larger than a quarter, changing a saturated pad/tampon every hour for more than two hours, bleeding longer than 7-10 days, or if you’ve just noticed a significant change in your menstrual flow. “An OB-GYN will generally take a good history of your bleeding pattern, do a speculum and pelvic exam, and likely order an ultrasound and lab testing based on the history and physical exam.”
“Abnormal clotting is most commonly related to heavy menstrual bleeding,” she adds, which could be normal for you, or it could indicate an underlying health concern. “The most common reasons for heavy menstrual bleeding are structural issues with the pelvic organs, hormonal changes, infection, bleeding disorders, or rarely, cancer in the uterus or cervix.”
Still, don’t panic; your doctor can help you rule out anything serious, says Purdie. “Treatment options will depend on the findings during the evaluation. In general, treatment for heavy bleeding and clots may be medical or surgical depending on the reason for the bleeding and the preference of the patient.” Your doctor will work with you on the best treatment plan and get you back to feeling better ASAP. There’s no shame or judgment in any questions you may have related to your cycle, and you don’t have to suffer through anything in silence.