Piece of Endometrial Tissue in My Period: 1 in 3 Women Ignore This Signal!

"I saw reddish lumps in my period..." This discovery can be confusing, even worrisome. However, before you panic, know that these tissue fragments can be perfectly normal. In this article, we decipher precisely what these pieces of endometrial tissue actually are, why they appear, and most importantly, when they deserve your medical attention.

What Are These "Pieces" In My Period?

L'endometrium is the lining of the uterus that thickens each cycle to accommodate a possible embryo. If pregnancy does not occur, it breaks down and is excreted during menstruation.

These fragments may look like:

• Personalized blood clots (dark red, gelatinous).
• Personalized shreds of fabric (thicker, pinkish or grayish).
• Pieces of uterine lining (spongy texture).

✅ When is it normal?

• At the beginning or end of menstruation : The uterus expels the last residues.
• Abundant periods : A heavy flow may result in a more visible expulsion.
• Postpartum or miscarriage : The uterus evacuates residual tissue.
• Concrete example : If the fragments are less than 2,5 cm (taille of a 2€ coin) and are not accompanied by extreme pain, it is generally benign.

🚨 When is it not normal?

• Very large fragments (> 2,5 cm, taille of a 2€ coin): May indicate hormonal imbalance or fibroids.
• Severe and persistent pain : Unbearable cramps, especially if accompanied by fever (risk of infection or endometriosis).
• Prolonged bleeding (> 7 days) or hemorrhagic : Risk of anemia or underlying pathology.
• Foul odor or colored discharge (green, gray): Possible sign of infection (e.g. vaginosis).
• Associated symptoms : Dizziness, pallor, extreme fatigue (signs of anemia or complication).

Endometrium & Menstrual Cycle: The Hormonal Ballet Decoded

The endometrium is much more than a simple mucous membrane; it is a complex ecosystem that transforms into a veritable "nest" each month, ready to welcome an embryo. According to a study published in Endocrine Reviews, this uterine layer can go from 1 mm to more than 7 mm thick in just two weeks!

The endometrial cycle in 4 stages

Your endometrium follows a precise rhythm, orchestrated by your hormones:

1. Menstrual phase (D1-D5) : Active shedding of the endometrium that has not been used
2. Proliferative phase (D6-D14) : Progressive reconstruction under the influence of estrogens
3. Secretory phase (D15-D28) : Complete maturation thanks to progesterone
4. Degeneration phase : In the absence of pregnancy, the endometrium begins to break down

It is during the menstrual phase that you may notice tissue fragments. These pieces of endometrial tissue are simply portions of your uterine lining that sometimes shed in larger fragments rather than microscopic particles.

How to Distinguish a Blood Clot from an Endometrial Fragment?

It can be difficult to tell the difference between a simple blood clot and a true fragment of endometrium. A clot is usually dark red to black in color and breaks up easily when handled. A piece of endometrium, on the other hand, has a firmer, tissue-like texture and ranges from pink to bright red in color. If you place them under water, the clot tends to dissolve while the endometrial tissue retains its structure.

Research published in Obstetrics & Gynecology show that up to 30% of women regularly confuse clots with tissue fragments, which can delay a diagnosis if necessary.

Lumps of Endometrial Tissue During Menstruation: Normal or Warning Sign?

Now that we've covered the basics, let's delve deeper into what medical science tells us about these fragments. The distinction between normal and abnormal is sometimes subtle. The American College of Obstetricians and Gynecologists specifies that small tissue fragments (less than 2,5 cm) are generally harmless, particularly if:

• They only appear during your period
• They are not accompanied by intense pain.
• Your bleeding remains within your usual norm
• Their presence is occasional and not systematic.

From what taille Is a piece of endometrium a cause for concern? Fragments larger than 2,5 cm (larger than a €2 coin) warrant medical attention, especially if accompanied by other symptoms such as severe pain or very heavy bleeding.

Potential Impact on Fertility

A common question is the impact of these fragments on fertility. Endometrial fragments themselves do not affect fertility. However, if their presence is due to an underlying condition such as endometriosis or fibroids, these conditions can indeed impact your ability to conceive.

A study published in Fertility and Sterility indicates that women with significant endometrial irregularities may experience a 15-20% reduction in their chances of natural conception per cycle, depending on the underlying cause.

The 5 Main Causes of Endometrial Fragments in Menstruation

There are several factors that can explain the presence of more visible tissue fragments in your period:

1. Hormonal imbalances

An imbalance between estrogen and progesterone can cause the endometrium to thicken excessively. When it sheds, it naturally forms larger fragments. Research published in Fertility and Sterility shows that up to 30% of women of childbearing age may experience periods of hormonal imbalance.

2. Uterine fibroids

These benign tumors, present in 20-80% of women before menopause, can distort the uterine cavity and alter the way the endometrium sheds. The result: larger lumps and heavier periods.

3. Endometriosis and adenomyosis

These conditions are characterized by abnormal growth of endometrial tissue. Adenomyosis, in particular, where the endometrium infiltrates the uterine muscle, can cause larger fragments to be expelled.

4. Early miscarriage

A pregnancy that is terminated very early can sometimes manifest itself by the expulsion of thicker endometrial tissue, often confused with particularly heavy periods.

5. Side effects of certain medications

Some treatments, particularly blood thinners, can promote the appearance of larger clots and tissue fragments during menstruation.

Could this be a Cancer sign?

Many women worry about whether these fragments could indicate cancer. This is a legitimate concern, but fortunately very rare. Endometrial cancer usually manifests as irregular bleeding or bleeding after menopause rather than as lumps of tissue.

According to the American Cancer Society, less than 3% of cases of abnormal bleeding with tissue fragments in women of childbearing age are linked to cancer. However, persistent and unexplained changes in your periods always warrant a medical consultation.

Diagnosis & Treatments: Adapted Medical Solutions

If you have abnormal or worrying pieces of endometrial tissue, your doctor may recommend several tests:

• Pelvic ultrasound: To visualize the thickness of the endometrium and detect possible fibroids
• Hormone dosages: To identify a possible imbalance
• Hysteroscopy: An examination that allows direct observation of the inside of the uterus
• Endometrial biopsy: To analyze a tissue sample in case of suspected pathology

Depending on the identified cause, different therapeutic options can be proposed:

Cause	Description	Things to do
Hormonal imbalance	Excess estrogen → excessive thickening of the endometrium.	Hormonal assessment + pill possible.
Uterine fibroids	Benign tumors disrupting the expulsion of the endometrium.	Ultrasound + gynecological follow-up.
Endometriosis	Fragments of endometrium outside the uterus → painful periods and thick tissue.	MRI + anti-inflammatory treatment.
Early miscarriage	Expulsion of embryonic tissue (often ignored as normal menstruation).	Pregnancy test + ultrasound.
Uterine polyps	Growths in the uterus → irregular bleeding.	Hysteroscopy for removal.

Hormonal Contraceptives: An Effective Solution?

Hormonal contraception, particularly the pill, generally reduces the thickness of the endometrium, which can reduce the presence of tissue fragments in your period. It is one of the first-line treatments offered for heavy periods with fragments.

Studies show a 70-80% reduction in menstrual volume in hormonal contraceptive users, which can significantly improve menstrual comfort and reduce the presence of tissue fragments.

Natural Approaches to Improving Endometrial Tissue Health

Beyond medical treatments, a study published in Advances in Nutrition shows that certain natural approaches can support endometrial health:

Nutrition and supplements

• Anti-inflammatory diet: Rich in omega-3, fruits, vegetables and low in ultra-processed foods
• Vitamin D: Essential for hormonal regulation and immune balance
• Magnesium: Helps reduce excessive uterine contractions
• Ginger and turmeric: Natural anti-inflammatory properties

Stress management and lifestyle

• Relaxation techniques: Chronic stress disrupts hormonal balance
• Moderate physical activity: Improves pelvic blood circulation
• Local heat: Hot water bottle or warm bath to relax the pelvic muscles
• Restorative sleep: Crucial for hormonal balance

When to Consult Without Hesitation

When faced with worrying symptoms related to your period and the presence of endometrial fragments, it is essential not to procrastinate. Seek medical help quickly if you notice:

• Extremely heavy bleeding (soaking a pad in less than an hour)
• Severe pain that does not respond to usual pain relievers
• Very large tissue fragments (more than 2,5 cm, i.e. larger than a 2€ coin)
• Persistent irregular bleeding
• Symptoms that worsen over time

Your doctor or gynecologist is best placed to assess your specific situation and offer you treatment tailored to your needs and lifestyle.