How to distinguish between the shedding of the endometrium during menstruation and blood clots

Patient's question:

I have an itchy lower body, and my underwear is always yellow. What's going on? How can I distinguish between the shedding of the endometrium during menstruation and blood clots?

Doctor's answer:

Menstruation is caused by the shedding of the endometrium, so the clots you see are the pieces of the shed endometrium. The presence of blood clots in the blood is related to the amount and speed of bleeding. If you bleed heavily and quickly, it may coagulate into a clot and be expelled, often indicating a larger amount of bleeding that has formed into a mass.

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