Spotting between periods is likely nothing to worry about, but heavy bleeding or passing large blood clots could be a sign of a serious health condition, such as endometriosis, uterine fibroids, or even cancer. If you’re passing large clots, speak with your doctor. They can help you determine what might be causing it and what treatment may be best for you.*

How to know if bleeding is not normal

It’s common to pass quarter-sized or smaller blood clots during the heaviest days of your period. Spotting between periods is also common and probably nothing to be concerned with. Passing large clots or bleeding heavily between periods, however, is not normal and may be a sign of an underlying health condition.

Other signs of abnormal menstrual bleeding include:

• Changing your pad or tampon every two hours or less,
• Using a pad and tampon at the same time,
• Soaking through pads or tampons during the night,
• Constantly feeling tired, and
• Bleeding that interferes with everyday life.

Possible causes of abnormal blood clots

There are many things that can cause you to pass clots between periods. Possible causes include:

• Uterine fibroids
• Uterine polyps 
• Endometriosis 
• Adenomyosis 
• PCOS
• Miscarriage
• Changes in hormones during the menopause transition
• Other health concerns, such as thyroid problems or cancer, although this is rare  

If you’re experiencing heavy bleeding or passing large clots between periods, your doctor may ask you to keep a period diary. This can help you track how heavy your periods are, how long they last, the size and frequency of clots, and how many tampons or pads you generally use. From there, they may suggest a pelvic exam, blood test, ultrasound, and/or other tests to get a better idea of what’s causing the excess bleeding.

Treatment options

If left untreated, heavy bleeding can affect other aspects of your health. In one study, researchers found that 63% of women with heavy periods also had iron-deficiency anemia, insufficient healthy red blood cells to carry oxygen throughout your body.

Available treatment options will depend on the cause of the bleeding. Depending on your situation, here are some treatments your doctor may suggest:

• • Medication: if you have uterine fibroids, they may suggest some sort of hormonal birth control. Hormone replacement therapy is often prescribed to help with menopause-related symptoms, and tranexamic acid or anti-inflammatory drugs, like ibuprofen, may also be able to help control bleeding.
  • Surgical options: If medication isn’t working, or if you need to have polyps or fibroids removed, your doctor may recommend a surgical procedure, such as myomectomy or uterine artery embolization. Endometrial ablation and/or hysterectomy may be suggested if you are not planning to have any children, going forward.

If you’re passing large clots or bleeding heavily between periods, speak to your doctor. They can help you find a treatment option that’s right for you.

*Jones, B. (2022, September 11). Passing Blood Clots and Not on Your Period? What It Means. Verywell Health. Retrieved September 21, 2022, from https://www.verywellhealth.com/passing-blood-clots-and-not-on-period-5189354