Does Clotting During Your Period Signal a Hormonal Imbalance?

BySamradni Pradhan
Updated: 11 Jun 2025, 2:00 pm

Noticing blood clots during your period can feel concerning, but in many cases, it’s a normal part of menstruation. However, clotting can sometimes point to changes in hormone levels or aspects of uterine health that may need attention. This blog gently explores what causes menstrual clotting, when it might reflect a hormonal shift, and when it’s a good idea to check in with a healthcare professional.

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When you see clots during your period, you may wonder what they are. Menstrual clots are dark red or nearly black, jelly-like masses of blood. They vary in size, from little specks to larger clumps about the size of a quarter.

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When your body is overwhelmed with the amount of blood due to uterine shedding, it causes blood pooling. This results in the coagulation of blood before it leaves your body.

Occasional clots during heavy flow days are common and not a concerning issue.

However, passing large clots is often a sign of an underlying condition. You may require medical assistance for it.


Why Do Blood Clots Form During Your Period?

To understand how clotting starts, it is essential to comprehend the process of the menstrual cycle. Your uterus creates a rich lining with numerous blood vessels each month. When there is no pregnancy, hormone levels drop, leading to the shedding of this lining. This is what you experience as your period.

Normally, blood flows smoothly during your menstrual cycle. But, in case of heavy flow, it can pool in your uterus before leaving the system. The pooling of blood causes blood to clot, especially if your body’s natural clot-preventing abilities are overwhelmed.

Many factors may influence blood clotting during menstruation, including:

  • Heavy menstrual bleeding (menorrhagia)
  • Uterine abnormalities, like fibroids or polyps
  • Hormonal fluctuations
  • Blood clotting disorders
  • Infections or inflammation


The Link Between Blood Clots and Hormonal Imbalance

Hormones are important for regulating your menstrual cycle, including the thickness of your uterine lining and the flow of your period. The two important hormones involved in this process are oestrogen and progesterone.

  • Oestrogen causes the uterine lining to thicken during the first half of your cycle.
  • Progesterone stabilises the lining after ovulation and prepares the uterus for possible pregnancy.
When the delicate balance between these hormones is off, it affects the shedding of your uterine lining. The heavy bleeding makes your blood clot.


How Does Hormonal Imbalance Cause Clotting?

The rise in oestrogen levels causes your uterine lining to become excessively thick. This means there is more blood to shed during your period. It also increases the likelihood of blood pooling and clot formation before it leaves your body.

On the other hand, if progesterone levels are too low, the lining may not stabilise properly, leading to irregular or heavier bleeding with clots. In conditions such as polycystic ovary syndrome (PCOS) or perimenopause, these hormonal imbalances become more common and may contribute to clotting during your period.


Common Hormonal Disorders Linked to Clotting

The presence of various hormonal disorders increases the chances of heavy periods and clotting:

  • PCOS: It causes irregular cycles and often high oestrogen compared to progesterone, resulting in a thick uterine lining and clotting.
  • Thyroid Disorders: Fluctuations in your thyroid levels affect your menstrual cycle and flow. Sometimes, it leads to clotting.
  • Perimenopause: Hormonal fluctuations during this transitional phase may lead to unpredictable cycles and heavier bleeding.
  • Luteal Phase Defect: When the second half of your cycle is shorter, or progesterone levels are insufficient, it can cause heavier bleeding and increased clotting.


When Is Clotting Normal During Your Period?

While clotting may be concerning, it is also quite common in the following scenarios.

  • Heavy flow days: Your body sheds more blood than usual, which can pool and clot.
  • First few days of menstruation: Heavy bleeding forms a clot during the first two days of your period.
  • Occasional clots: Sporadic clots do not cause a problem.
Clots are usually harmless, especially when they are small, around the size of a raisin or smaller. There’s generally no cause for concern if your overall bleeding isn’t heavy.


When Should You Be Concerned About Clotting?

You should consult a doctor in case of:

  • Large clots (bigger than a quarter)
  • Clots accompanied by heavy bleeding, soaking through a pad or tampon every hour
  • Severe cramps or pain during menstruation
  • Periods lasting longer than seven days
  • Fatigue, dizziness, or other symptoms of anaemia
  • Clots accompanied by irregular cycles or spotting between periods
These symptoms may indicate underlying health issues, such as hormonal imbalances or uterine abnormalities, that require medical evaluation.


Other Causes of Clotting to Consider

Hormonal issues are not the primary cause of clotting, and the following factors may also contribute to it.

  • Fibroids: These are noncancerous tissue growth in the uterus, leading to heavy bleeding.
  • Polyps: These small growths on your uterine lining cause either spotting or clotting.
  • Adenomyosis: Heavy bleeding occurs due to the growth of muscular tissue on your uterine lining.
  • Blood clotting disorders: Some rare conditions impact your blood clotting ability.
  • Medications: Certain blood thinners or hormone treatments also affect your bleeding.
Your doctor may recommend an ultrasound, along with other tests, to determine the cause before treatment.


How Can You Manage Clotting Related to Hormonal Imbalance?

Restoring your hormone levels is the first line of action when clotting occurs due to a hormonal imbalance. The following are some common approaches.

  • Hormonal contraceptive: Birth control pill, patch, or IUD helps in restoring oestrogen and progesterone levels. It also reduces heavy bleeding and clots.
  • Lifestyle changes: A healthy weight, managing stress, and avoiding smoking maintain hormonal balance.
  • Medications: Your doctor may prescribe medicines to reduce bleeding or regulate your menstrual cycle.
  • Surgical options: For uterine issues like fibroids, respective procedures may be necessary.


When to Seek Professional Help

If you are unclear about whether your clotting is normal or an issue, keep track of your menstrual cycle.

  • Length and regularity of your cycles
  • Size and frequency of clots
  • Amount of bleeding (pads/tampons used per hour)
  • Symptoms, such as pain or fatigue
Sharing this information with your doctor will help diagnose the underlying cause and suggest treatment.

Clotting is a completely normal part of your menstruation during the initial heavy flow days. However, frequent or large clots may indicate a hormonal imbalance or other underlying health issues. By understanding the role of hormones in your menstrual cycle and recognising clotting issues, you can take informed steps to protect your reproductive health.

Regarding any changes in your cycle or symptoms that affect your quality of life, consult your doctor for medical guidance.


FAQs on Does Clotting During Your Period Signal a Hormonal Imbalance?

  1. Can hormonal birth control help reduce period clots?
    Yes, hormonal birth control regulates your cycle and also reduces heavy bleeding. Also, it can help reduce the clotting frequency and size.
  2. Are blood clots during pregnancy a cause for concern?
    Bleeding with blood clots during pregnancy is not normal and should be evaluated by a doctor. While light spotting can occur in early pregnancy, passing clots may signal an underlying issue and require medical attention.
  3. Can diet impact hormonal balance and clotting?
    A diet that includes whole foods, vitamins and minerals supports your hormonal and overall health. However, you may not prevent clotting by diet because of other medical concerns.
Disclaimer: Medically approved by Dr Neerja Goel, Senior gynecologist from Shardacare- Healthcity