###Human: What does passage of a clot followed by continuous vaginal bleeding indicate? ###Assistant: Hi. I have read your concern. It is good you have already ruled out pregnancy because, in any type of abnormal bleeding among reproductive age, pregnancy is one of the first condition that should be ruled out. The second most common cause of these types of bleeding is a hormonal imbalance. Theoretically, your progesterone hormone should be elevated on the second half of your cycle and decreases when you are nearing the start of your period. So the amount of this hormone is critical in making you bleed. If there is too slow of a decrease or too abrupt or most the time insufficient amount, then it will affect the timing of the bleeding and will cause heavy bleeding. The treatment for this is oral Progesterone or in the form of birth control pills. The third common cause would be a structural problem, the presence of a polyp, myoma or endometrial lining problem, infection, etc. These situations will need ultrasound and evaluation by an ob-gyn. For your case, I suggest you take first Ibuprofen thrice a day for the first 3 to 4 days of your period. This would help in decreasing the bleeding and at the same time avoid pain. You may opt to observe this cycle of bleeding for another month or it would be more helpful to have a scheduled appointment with your ob-gyn for the next month.