Causes of Menstrual Clots and Treatment

23 February, 2021
Menstrual clots are common. In general, these are due to temporary hormonal changes, although some cases require medical control. Today's article will explain the most frequent causes.

Menstrual clots are a source of concern among women. Thus, it’s common to worry these may be due to a serious health condition.

However, you should know that menstrual clots are of hormonal origin. As such, menstruation returns to normal once the hormones rebalance.

It’s also true that this condition might require intensive monitoring. It’s not common, but menstrual clots could be a warning sign of uterine pathologies.

As you probably already know, menstruation is the event by which the endometrium comes out. The endometrium is the innermost layer of the uterus and cyclically sheds to start the formation of a new layer when there’s no pregnancy.

This shedding manifests externally as bleeding. Under regular conditions, the blood is red and has no clots.

Also, keep in mind that clots are the mechanism by which the human body stops bleeding. These stop bleeding after an injury or any other possibility of excessive blood loss.

Clots are usually darker than fluid blood in any organ in which they form and have a gelatinous consistency. In fact, they resemble a small ball that agglutinates the blood elements.

People tend to assume that the body is trying to stop bleeding when menstrual clots appear. This is probably because clotted menstrual bleeding is darker and, of course, not as fluid.

Uterine causes of menstrual clots

  • Uterine polyps are tissue formations that protrude into the cavity of the uterus. Furthermore, these modify the endometrium by pushing on it and obstructing the outflow of menstrual blood. The blood remaining retained inside the uterus for a longer period of time is what comes out as clots.
  • Adenomyosis happens when the muscle of the uterus enlarges due to other surrounding tissues invading it — it’s similar to what happens with polyps. The modification of the endometrium and the obstruction to the exit lead to clots.
  • Endometriosis is a condition in which endometrial tissue grows in organs other than the uterus. It’s a disease of the endometrium and menstrual clots are one of the symptoms.
  • Uterine hypertrophy means the uterus may have become enlarged due to physiological causes or disease. For instance, it’s normal for them to happen during pregnancy and the months following childbirth. This is because there’s more endometrial surface area and space for blood clots to accumulate blood, and they’ll form spontaneously.
  • One of the symptoms of miscarriages is the expulsion of clots via the vagina — as if it were menstruation. This isn’t strictly a regular menstrual cycle when it happens early in gestation but the dates often overlap and lead to confusion.
A knit drop of blood.
Blood clots during menstruation can have both uterine and extrauterine causes.

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Extrauterine causes of menstrual clots

Some situations bypass the uterine organ as such and are systemic or external. These conditions can lead to menstrual clots:

  • Hormonal changes are the most frequent and benign cause. In general, these resolve by themselves with the passage of time and there’s no need for medical intervention.
  • A hematological condition linked to blood coagulation affects a woman’s menstruation. A common example is von Willebrand’s disease. Blood stores in the uterus and then coagulates by producing abundant bleeding, although it’s a coagulation deficit.
  • Intrauterine devices, known worldwide as IUD, are contraceptive methods that have menstrual clots as one of their side effects. Thus, a woman should consider removing the device if these persist and alter their quality of life.
  • Anemia causes menstrual clots and it’s the beginning of a vicious circle in the woman afflicted by it. This is because heavy menstrual bleeding leads to anemia due to iron losses and so there’s less iron in the body. The uterus reduces its clotting power without adequate iron and the amount of blood loss increases.
A woman lying on the coach aflicted by menstrual cramps.
The presence of severe menstrual cramps along with clots is a symptom that you should consult a health professional.

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When to see a doctor

Most women with menstrual clots don’t require medical consultation. However, the following warning signs do require a visit to the doctor:

Finally, consult a doctor or specialist if you have any doubts about what’s going on in your body. It’s better to analyze the characteristics of menstrual blood and rule out anemia in time. Also, complex complementary methods aren’t necessary to reach a diagnosis.

  • Roselló-Soberón, María Emilia, et al. “Ciclo menstrual y alimentación.” Perinatologia y reproducción humana 17.2 (2003): 61-71.
  • Jiménez, MJ Rodríguez, and N. Curell Aguilá. “El ciclo menstrual y sus alteraciones.” Pediatria integral 21 (2017): 304-311.
  • Arteaga, Eugenio, and C. Fernández. “Trastornos menstruales en la adolescencia.” ARS MEDICA Revista de Ciencias Médicas 16.2 (2017): 15-19.