46 bleeding over a month extremely heavy very large clots some pain?

Like fibroids: You likely have uterine fibroids. Consult with Gynecology, but also check CBC to make sure that you are not anemic

See a physician: See a doctor to get checked. While abnormal bleeding probably represents fibroid uterus, other potential causes of bleeding include cervical cancer, uterine canceretc.. need to be excluded. A few simple tests such as an ultrasound will help sort this out.

See the gynecologist: You should definitely make an appointment ASAP with your gynecologist who will likely recommend an exam, biopsy, blood work and pelvic ultrasound.