What Can Cause Continual Vaginal Bleeding With Large Clots

Passing blood clots or a sudden gush of blood when you're not on your period is common among people with a menstrual cycle. They can be caused by hormonal changes from menopause or polycystic ovary syndrome (PCOS), uterine growths, or thyroid issues.

Clots are most common when period blood is at its heaviest. Passing blood clots outside of a period isn't always a major concern, but it can be—especially if they are large.

Blood clots that appear when you are not having your period can be caused by a range of issues. But since some of them can be serious—including uterine fibroids, bleeding disorders, miscarriage, and cancer—it's best to see a healthcare provider.

This article explains what passing blood clots when not on your period might mean, and why it may be important to see a healthcare provider. It explains how the causes of these clots and any related symptoms like fatigue are diagnosed and treated.

Verywell / Laura Porter

Signs Passed Blood Clots Are Abnormal

Spotting, which is when you bleed just a few drops of blood between periods, is not uncommon or of concern in most cases. Bleeding between periods becomes more worrisome if you regularly pass large blood clots.

Speak to a healthcare professional if you bleed heavily during or between periods or you pass blood clots that are larger than a quarter.

The following are additional signs that vaginal bleeding is too heavy:

• Bleeding that soaks through a pad or tampon every two hours or less
• Needing to use both a pad and tampon together to control bleeding
• Needing to change your tampon or pad throughout the night
• Bleeding that prevents you from daily activities, work, or school
• Fatigue
• Shortness of breath
  

What Causes Abnormal Clots Outside of a Period?

Clot formation can last longer in those with heavy menstrual flow. About 33% of people with a uterus have periods so heavy that they soak through a pad or tampon every hour for several hours.

Possible medical causes for passing clots when not on your period include:

• Hormonal imbalances: Perimenopause, which is the stage right before menopause, and menopause, which is diagnosed when your periods stop for at least a year, can cause irregular shedding of the uterine lining. This can result in clotting and heavy bleeding.
  
• Uterine fibroids: These are noncancerous growths that develop in or around the uterus and can cause heavy or painful periods, as well as blood clots.
• Endometriosis : In this condition, the endometrium is found outside the womb in other organs, such as in the ovaries. This can lead to irregular periods and blood clots that look like they're typical of a heavy period.
• Adenomyosis : This is a condition in which the endometrial tissue that normally lines the uterus breaks through and begins to grow into your uterine wall. This can lead to heavy periods and clots.
  
• Miscarriage: Pregnancy loss can happen very early, sometimes before you even know that you're pregnant. Clotting and bleeding are common symptoms.
• Uterine or cervical polyps: These are growths on the uterus or cervical canal, which connects the uterus to the vagina. These can lead to heavy bleeding and clots.
• Cancer in your uterus or cervix: This is a potential but less likely source of blood clots.
  
• Other medical conditions: Hypothyroidism, which occurs when your thyroid doesn't make enough thyroid hormone, and polycystic ovary syndrome (PCOS), which is when multiple cysts grow on the ovaries, can lead to clotting and heavy bleeding.

Risks of Passing Blood Clots

Long-term heavy menstrual bleeding is a common cause of iron deficiency anemia, a condition where there aren't enough red blood cells in the body. In fact, one study found that about 63% of those who experienced heavy periods also had anemia.

Symptoms of anemia may include:

• Fatigue, or low energy
• Weakness
• Pale skin
• Shortness of breath
• Difficulty concentrating
• Feeling dizzy

Speak to a healthcare provider if you are experiencing any of these.

Diagnosing Blood Clot Conditions

Your healthcare provider may ask you questions about your medical history and your period to find out what is causing your irregular clotting. You may be asked to keep a period diary to track the heaviness of your period, if you had clots, and how many period products, like pads or tampons, you used.

Next, your healthcare provider may do a pelvic exam. They may also want to do some tests including:

• Blood test: This may be used to check for hormonal and blood clot issues, as well as low iron levels.
• Pap test: Your cervix is swabbed to get a sample of cells to see if any abnormal changes might be the cause of heavy bleeding and/or clots.
• Endometrial biopsy : In this procedure, a sample of your uterine tissue is taken to check for abnormal cells.
• Ultrasound: This procedure uses sound waves to check blood flow and to look for fibroids or endometriosis in your uterus.

To diagnose your condition, your healthcare provider will take your medical history, give you a physical exam, and may also order specific tests to better understand what's going on.

How Are Blood Clots Treated?

The treatment for your blood clots will depend on the underlying cause and may include medication or surgery.

Medication

Medication options may vary, depending on the reason for passing blood clots and the specific condition. These options include:

• Hormonal birth control methods can often manage heavy bleeding caused by endometriosis, PCOS, and fibroids.
• Hormone therapy can be helpful for heavy menstrual bleeding that occurs during perimenopause. It reduces perimenopause symptoms by replacing the hormones that naturally stop being made during this time.
• Tranexamic acid  is a prescription medication that treats heavy menstrual bleeding. It comes in a tablet and is taken each month at the start of your period.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) , such as Advil (ibuprofen), may help with heavy bleeding, including clots, and relieve period cramps.

Surgery

Surgical treatment may be an option for you if you need to have polyps or fibroids removed. Your healthcare provider may also recommend surgery if medication hasn't remedied the issue. Potential surgeries include:

• Uterine artery embolization (UAE) is used to treat fibroids. In UAE, the blood vessels to the uterus are blocked, which stops the blood flow that allows fibroids to grow.
• Myomectomy is surgery that removes uterine fibroids without removing the uterus.
• Hysteroscopy may be used to remove fibroids or stop bleeding caused by fibroids.
• Endometrial ablation  removes the lining of the uterus. It stops or reduces menstrual bleeding.
• Hysterectomy is the surgical removal of the uterus. It is used to treat fibroids, adenomyosis, and endometrial cancer. After the uterus is removed, you will no longer have periods and can no longer get pregnant.

Summary

Passing blood clots while on your period is nothing to worry about. However, frequently passing large clots that are larger than a quarter and bleeding heavily in between periods warrants a call to your healthcare provider.

Abnormal clotting may be caused by hormonal imbalances, certain medical conditions, and some types of cancer.

Frequently Asked Questions

• What are passed blood clots made of?

  Blood clots may include a mix of blood, dead cells, and the top layer of the uterine lining known as the endometrium. They are jelly-like and can be bright to deep red.
  

• Is it normal to have golf-ball-sized blood clots?

  It is not normal to have blood clots larger than a quarter. You should consult your healthcare provider any time you have large blood clots during your period or outside of your period.

• Why am I experiencing a sudden gush of blood if I am not on my period?

  Abnormal vaginal bleeding may occur if you have perimenopause, fibroids, certain cancers, and hormone imbalance-related issues. A miscarriage or other pregnancy-related issues can also trigger this.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. American College of Obstetricians and Gynecologists. Heavy menstrual bleeding.

2. Centers for Disease Control and Prevention. Heavy menstrual bleeding.

3. Kocaoz S, Cirpan R, Degirmencioglu AZ. The prevalence and impacts heavy menstrual bleeding on anemia, fatigue and quality of life in women of reproductive age.Pak J Med Sci. 2019;35(2):365-370. doi:10.12669/pjms.35.2.644

4. Penn Medicine. What is anemia.

5. Matteson KA, Rahn DD, Wheeler TL, et al. Nonsurgical management of heavy menstrual bleeding: a systematic review.Obstet Gynecol. 2013;121(3):632-643. doi:10.1097/AOG.0b013e3182839e0e

6. Michigan Medicine. Abnormal vaginal bleeding.

By Brandi Jones, MSN-ED RN-BC
Brandi is a nurse and the owner of Brandi Jones LLC. She specializes in health and wellness writing including blogs, articles, and education.

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Source: https://www.verywellhealth.com/passing-blood-clots-and-not-on-period-5189354

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