“Doctor, my period is heavy and has large clots. Is it dangerous?”
“I usually experience menstrual cramps at the start of my period, but the pain stops after passing large clots. Is this a health issue?”
For modern women who want to take care of their health, the most important step is to observe and record their monthly menstrual cycles. During annual health checkups, doctors often inquire about your menstrual history, from the cycle length to the number of days, as menstruation is a vital indicator of your overall health.
Traditional medicine places significant importance on gynecology, focusing on menstruation, discharge, pregnancy, and childbirth. In addition to recording the cycle and duration of each period, doctors may also ask about the volume, color intensity, clotting, and discomforts like cold hands and feet, menstrual cramps, bloating, diarrhea, or sweating—all common issues women may face during menstruation.
Is sudden menstrual clotting a cause for concern?
Clotting during menstruation is often a concern for many women. Typically, menstrual blood is bright red or dark red and is absorbed by sanitary pads. However, blood clots tend to accumulate on pads, which can be uncomfortable. When clots turn dark red or liver-like in color, they can seem alarming. Why does sudden clotting occur, and what should you do about it?
Occasional clotting is generally not worrisome and is part of the body’s natural clotting mechanism. Similar to how small clots form inside the nose after a nosebleed, the uterine cavity, being much larger, produces more clots. However, if large clots occur every cycle and persist for months, it’s advisable to consult a gynecologist, as this could be caused by uterine fibroids leading to heavy and clotted menstrual bleeding.
How to manage excessive clotting during menstruation?
Heavy clotting may be a sign of uterine fibroids.
During menstruation, the uterine cavity secretes "antithrombin" to prevent clotting and allow blood to flow smoothly. However, when the volume of menstrual blood exceeds the capacity of antithrombin, some blood may clot before being expelled.
If clotting occurs occasionally or the blood is dark, it could be due to poor uterine contractions, slow shedding of the endometrial lining, or blood clotting before expulsion. While this is generally harmless, you should still monitor the situation. If clotting is frequent, accompanied by menstrual cramps, it could indicate fibroids, uterine polyps, or polycystic ovary syndrome (PCOS) caused by hormonal imbalances.
5 common menstrual conditions
Condition 1: Bright red menstrual blood
Bright red blood at the start of your period indicates rapid shedding of the uterine lining. After the period ends, the uterus will be cleaner.
Condition 2: Dark red or brown menstrual blood
Dark red or brown blood near the end of your period is normal. If your cycle is regular, this suggests good health. However, if dark blood is excessive and sticky, it may indicate slightly elevated estrogen levels.
Condition 3: Heavy menstrual flow
A sudden increase in menstrual flow lasting more than a week could be due to uterine fibroids or polyps. Polyps often don’t require treatment, but fibroids might need medication. Copper-based IUDs can also increase menstrual flow. Always consult a doctor for appropriate treatment.
Condition 4: Menstrual blood with clot
Dark red clots smaller than 1/4 of the total blood volume are normal, as the uterus clears out impurities. Sitting too long can also lead to clots when standing. However, frequent clotting with cramps may indicate fibroids, polyps, or PCOS caused by hormonal imbalances.
Condition 5: Black clots
Black clots on sanitary pads are caused by oxidation. Menstrual blood is rich in iron, and prolonged exposure to air oxidizes the iron, darkening the color. To prevent this, change pads regularly (every two hours).
Clotting and heavy bleeding during menstruation not only raise health concerns but also inconvenience daily life. Frequent pad changes are necessary to prevent leaks, but clotting may still cause dizziness and fatigue.
Traditional medicine aims to identify the root cause and provide targeted treatments for women experiencing heavy clotting. Improving blood circulation and clearing blood stagnation can help regulate menstrual flow. Women with “Qi deficiency,” “liver Qi stagnation,” or “blood stasis” may not necessarily have fibroids or polyps but can still benefit from traditional Chinese medicine for excessive clotting.
Whether caused by physical constitution or conditions like fibroids, polyps, endometriosis, or abnormal blood clotting, medical treatment is essential. A healthy diet and regular exercise play a critical role in improving blood circulation and stabilizing hormones, reducing or even eliminating clotting.
Our bodies are a gift from our parents, but health is something we must nurture ourselves. By taking care of your body, your monthly cycle will stabilize, and your natural beauty will shine!
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Author Information:
Dr. Charlotte Duh (杜丞蕓) – Licensed Traditional Chinese Medicine Physician (USA).
Dr. Charlotte Duh holds a Master’s degree from National Taiwan University/USA and is the author of several health-focused books, including For Women Only, Timeless Beauty, and Nutrition for Rejuvenation.
Dr. Charlotte Duh specializes in gynecology, internal medicine, and pediatrics. She is experienced in natural medicine and holistic therapies from various countries and offers modern interpretations of traditional Chinese medicine, medicinal diets, meridian therapies, and yoga. She hopes women can use the safest, non-toxic methods to enhance their beauty and youthfulness.