Here's a "fun" fact: People who menstruate spend an average total of SEVEN YEARS of our lives on our periods. At the same time, menstrual stigma often holds us back from talking about our period experiences, so we don't always know what's considered normal and healthy — and what could be a symptom of an issue that needs to be addressed.
According to Tara Brandner (@tarabfertility), a 36-year-old doctorate nurse practitioner and fertility coach in North Dakota, too many people's concerns about their menstrual cycles get written off and ignored by medical professionals. So, she took to TikTok to spread the word about what's normal and what's not when it comes to period clots.
And, uh, as someone who's been passing clots for over 20 years at this point, I was like, Wait, what?? And in the comments, lots of other viewers had the same reaction.
Tara elaborated in a follow-up video, saying, "Let's talk size. If you are consistently passing clots larger than the size of a quarter, not normal. So, for all of you seeing golf ball, palm-sized [clots], find a new OBGYN."
In the comments, many people shared that doctors have told them that having large period clots is normal.
I absolutely had to know more, so I reached out to Tara. She says, "Passing of small clots during your period, approximately the size of a dime, without any other concerning symptoms, is normal. During our menstrual cycle, the lining of the uterus sheds due to a decline in progesterone levels, reducing the blood flow to the uterus. The body's clotting mechanisms are activated to form the clots and prevent too much blood from being released."
And what might those "concerning symptoms" be, you ask? She says, "These symptoms include, but are not limited to, intense cramping, nausea, fatigue, vomiting, dizziness, diarrhea, migraines, significant mood changes, changing products every one to two hours, and bleeding longer than seven days."
Tara says that large clots can be caused by a variety of conditions, including thyroid issues, fibroids, polyps, endometriosis, blood disorders, PCOS, and even IUDs and birth control pills. "Many of these conditions have red flag symptoms associated with them that would indicate an appointment should be made with your healthcare provider. These include lower back pain during a period and outside of it, pain during intercourse, bloating, spotting outside of your menstrual cycle, and fertility issues."
For a second opinion, I reached out to Dr. Marieme Mbaye, an OB-GYN who practices in New York.
Dr. Mbaye reiterated that period clots aren't always a sign of trouble. "For most people who have periods, blood clots are normal and nothing to be concerned about. They're actually very common in the mornings or after sitting down for a while because the blood sits in your vagina and clumps together."
And she says that it's also common to see more clots on your heavier days. "When your flow is heavier, expect to see more or larger blood clots because there's a larger amount of blood sitting in the uterus and vagina."
But she says large clots and other symptoms can point to an issue. "That said, one sign of an abnormal blood clot is that it's bigger than a quarter (normal period blood clots are usually the size of a dime). Other signs that something could be wrong include an excessive amount of blood clots, heavy menstrual bleeding (i.e., changing your pad or tampon after less than two hours), bleeding for more than seven days, severe abdominal pain, or nausea/vomiting."
If you have concerns about your clots, Dr. Mbaye recommends making some notes to prepare for your appointment so you don't forget to tell your doctor anything important. "Before you even see the doctor, make sure you've written down your concerns — the more detailed the better. We don't need to see a picture of any clots per se, but we want to know how big they are, how often you've seen them, and if they're a change from your past periods."
"It's also helpful to write any specific questions down ahead of time. If you're allowed to bring another person with you, they can also help support you. Sometimes, though, you may need to ask for a referral to another specialist or go to a different practice for a second opinion."
Tara says she made the video to raise awareness that period clots can be a sign of other issues, and to encourage people who've had these symptoms dismissed by doctors to get another opinion. "Many women have been dismissed with their symptoms of concern, even after seeing multiple providers, and I want to empower them to take back control of their healthcare and find a new provider who will listen to them and provide a workup."
"I am passionate about educating on medical gaslighting. Unfortunately, it happens so often. The comments on those TikToks are full of examples of that. If a woman feels brushed off during a medical appointment, doesn't feel heard, or returns with ongoing symptoms that are not being addressed appropriately, these are all signs that they need to find a new provider."
Not sure if you've experienced that? Tara says there are some red flags to look out for. "Signs of medical gaslighting to watch for are being told there's no further workup they can do to investigate your symptoms further. If your medical provider is pushing their degree or expertise to prove you wrong, red flag. If you feel minimized instead of engaging in a two-way conversation with your healthcare provider, find a new one. Also, if your provider isn't willing to run more tests for you and they won't explain why you don't need them, red flag."
Finally, she hopes her videos can inspire people to stop settling for healthcare providers who don't address their concerns. "I hope women feel empowered to take back control of their healthcare and realize they have the power to find a healthcare provider who will listen to them and address their concerns and needs. Feeling heard and connected with your provider is so important to successful health outcomes."