Heavy Menstrual Clots and Strong Odor: Is It Normal or a Sign of Infection?

Q: Heavy Menstrual Clots and Strong Odor: Is It Normal or a Sign of Infection?

Hello Ms. <br>Wu： It is normal to have blood clots during your menstrual cycle. <br>Objectively speaking, if the maximum menstrual flow does not exceed 8 sanitary pads in one day and there are no signs of anemia, it falls within the normal range. <br>The Hualien Hospital of the M

Menstruation with a significant amount of blood clots and a strong odor?

Last time, I went for a gynecological examination due to blood-tinged discharge.
After an invasive examination, the doctor said my uterus is normal, but I have polycystic ovary syndrome.
This time, during my menstrual period, I suddenly passed a lot of blood clots that felt like lumps, with a color similar to that of pig's blood but a bit lighter, and the odor was quite strong, though it didn't smell metallic like blood.
I would like to know if this is normal or if there might be an infection issue.

Wu, 20~29 year old female. Ask Date: 2018/08/30

Dr. Lin Manying reply Obstetrics and Gynecology

Hello Ms.
Wu: It is normal to have blood clots during your menstrual cycle.
Objectively speaking, if the maximum menstrual flow does not exceed 8 sanitary pads in one day and there are no signs of anemia, it falls within the normal range.
The Hualien Hospital of the Ministry of Health and Welfare cares about your health.

Reply Date: 2018/08/30

More Info

Heavy menstrual clots and a strong odor during menstruation can be concerning, and it's important to understand the potential implications of these symptoms. While some variations in menstrual flow and characteristics can be normal, significant changes may indicate underlying issues that require attention.

Firstly, menstrual clots are common, especially during heavier menstrual periods. Clots can vary in size and color, and they are typically dark red or brown, resembling "old blood." The presence of clots can be attributed to several factors, including hormonal imbalances, uterine fibroids, or conditions like polycystic ovary syndrome (PCOS), which you mentioned you have. In PCOS, irregular ovulation can lead to heavier and more prolonged menstrual bleeding, which may result in the formation of clots.

However, the strong odor you described is particularly noteworthy. A foul or strong odor can sometimes indicate an infection, such as bacterial vaginosis or a sexually transmitted infection (STI). These infections can alter the normal flora of the vagina, leading to an imbalance that may produce a strong odor. Additionally, if there is any tissue retention in the uterus, such as from a miscarriage or incomplete abortion, this can also lead to a foul smell due to the decomposition of retained tissue.

Given your history of polycystic ovary syndrome and the recent changes in your menstrual cycle, it would be prudent to consult with your gynecologist again. They may recommend further evaluation, including a pelvic exam, ultrasound, or laboratory tests, to rule out any infections or other underlying conditions. It's essential to monitor for additional symptoms, such as fever, severe pain, or unusual discharge, as these may warrant immediate medical attention.

In summary, while heavy menstrual clots can be a normal occurrence, especially in the context of PCOS, the strong odor you are experiencing is a symptom that should not be overlooked. It is advisable to seek medical advice to ensure that there are no infections or other complications that need to be addressed. Regular follow-ups with your healthcare provider can help manage your symptoms and maintain your reproductive health.

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