Decoding menstrual mysteries: Are blood clots during a period normal?

Raise your hand if you’ve ever jokingly been compared to a strawberry-juice dispensing machine on your period. (I would have raised mine, but who will write this story then?)

Well, as gross as this comparison sounds, it sort of makes sense—especially if you notice blood clots in your menstrual blood. I am talking about the dark red jelly-like globs of coagulated blood, which almost look like strawberry jam. You might find them sticking on your sanitary napkin or notice them when you pee. 

But, what are these lumps, really?
“Menstrual clots are a mixture of blood cells, blood by-products, mucus and tissue from the lining of the uterus and proteins in the blood,” explains Dr Lakshmi Aswathaman, senior consultant and clinical coordinator, Department of Obstetrics and Gynaecology, MGM Healthcare, Chennai.

And why do they happen in the first place?
Ladies, y’all know that the lining of the uterus grows and thickens throughout the month in a bid to prepare for pregnancy. When that doesn’t happen, the lining breaks down and settles at the bottom of the uterus, waiting to get released out of your body through the cervix. And that’s how you get your period.  

But what you probably don’t know is that the uterine lining also contains plasmin, an enzyme that tends to prevent the blood from clotting in order to facilitate its easy flow through the cervix without causing cramping. 

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“When the blood flow outpaces the body’s ability to produce anticoagulant plasmin, the coagulation proteins within the blood may start to cause clumping, resulting in menstrual blood clots,” Dr Aswathaman explains. 

Are they as scary as they seem?

Take a chill pill girls because according to Dr Nisha Jain, gynaecologist at Saroj Super Speciality Hospital, small blood clots are absolutely okay. As long as they occur in the beginning of your period and don’t happen regularly. 

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“However, menstrual blood clots are considered to be abnormal if they’re very dark red in colour, are larger than the size of a coin, and are accompanied by a heavy menstrual flow because of which a woman might have to change her sanitary napkin or tampon every one hour or two,” warns Dr Jain.

“This type of heavy blood flow usually lasts for more than seven days. If you are experiencing it, then you should immediately consult your doctor,” she adds.

In fact, Dr Aswathaman is quick to point out that heavy clotting can cause anemia, pale skin, tiredness, fatigue, shortness of breath, fainting, dizziness, low blood pressure, severe constant lower abdominal pain, and general weakness.

Taking these precautionary steps can help you keep those clots under control
The chances of you clotting more than normal go up majorly when you bleed heavily during your period. So, taking these precautions can ensure that your period flow doesn’t tamper with your health: 

1. Up your iron and vitamin C intake

“Consume foods such as meat, seafood, beans, legumes, citrus fruits, juices, nuts, seeds, dark molasses, green leafy vegetables, cereals, grains, and breads that are fortified with iron,” says Dr Aswathaman.

2. Keep yourself hydrated
If you bleed heavily, your blood volume can go down. So, she recommends drinking four to six extra cups of water a day to maintain your blood volume. You can also drink electrolyte solutions or add more salt to your diet to balance out the extra fluid you’re drinking.

3. Stay well-equipped

Jain recommends wearing two pads and dark-coloured lowers on the days when your blood flow is heavy. Additionally, spreading towels on your bedsheet at night can avoid staining. Not to mention, changing your pad or tampon at small intervals can help your case too.

That said, don’t take larger than normal clots during periods lightly as they can be indicators of something way more serious.

Here are a few possible health conditions that can be the real reason behind why you’re clotting:

1. Uterine obstructions or fibroids
Dr Aswathaman warns about the possibility of a blockage in the uterus due to fibroids (unwanted growths in the uterus) that may be stopping your uterus from contracting the way it actually should. The blood in this case will be released from your body at a slower pace, thereby getting enough time to clot or form lumps.

2. Endometriosis
“This is a condition where the uterine lining grows outside the uterus and into the reproductive tract,” she explains. As a result, the hormonal changes during menstruation can cause this misplaced tissue to become inflamed and your menstrual flow can be heavy, painful, and full of clots.

3. Adenomyosis
When the uterine lining grows into the muscular wall of the uterus in a condition known as adenomyosis, it makes the uterine wall thicker. This leads to a much heavier flow during a period and can form more blood clots, according to Dr Aswathaman.

4. Cancer
As unfortunate as this sounds, the truth is that cancerous tumours in the uterus and cervix can also be the cause of a heavy menstrual bleeding and blood clots.

5. Von Willebrand Disease
A bleeding disorder, this is caused by a deficiency of Von Willebrand Factor (VWF) in the blood. “If your levels of functional VWF are low, your platelets won’t be able to clot properly, leading to a heavy menstrual flow,” Aswathaman warns.

6. Hormonal imbalances
If the levels of certain hormones like oestrogen and progesterone are unbalanced, many issues can occur, including heavy menstruation and clotting during periods.

The final word…
Ladies, your menstrual health is important. So, relying solely on a balanced diet or keeping yourself hydrated won’t solve your problem if the underlying cause for clotting is something more serious. So, take no risks and waste no time. If you notice clots which are bigger than usual, visit a gynaecologist for a proper diagnosis and treatment.