How Heavy is Too Heavy? Understanding Period Flow

by Oct 18, 2024Menstrual Health Education

Rachel Price, Period Pro from Marshall Medical School

 

It’s normal for periods to vary each month, especially in the beginning. But how can you tell if your flow is typical, or when it’s considered too heavy? Heavy menstrual bleeding actually affects about 35% of menstruators, but many times, it “runs in the family” so it’s perceived to be normal.  

The amount of bleeding during a period can be measured in several ways- including how many days and how often you have your period, how many products you use daily, and even measuring the amount of menstrual blood.

Generally, periods last between 2 to 7 days. The heaviest flow tends to be during the first 1 to 3 days, then it lightens up as it wraps up. 1 Anything longer than a week can be considered heavy.  And here’s an important fact:  for the first few years after menarche (the first period), periods can occur every 21 to 45 days.1 So, if your period is happening more often than every 21 days, this can also be an indicator of heavy bleeding. After a few years, your cycle will usually settle into a more regular rhythm, occurring every 25 to 35 days. 

The length of a period and how often they happen varies from person to person, so when discussing “heavy” periods, we also need to consider the amount of blood lost.

During a period, most people lose between 2 to 4 tablespoons (around 60ml) of actual blood and over 80 ml is considered heavy. 2  However, you don’t need to measure this at home. Keeping track of the number of period products you use and how often you change them over a couple of cycles is a great place to start if you’re worried about heavy bleeding. This allows your doctor to estimate the amount of blood you’re actually losing. And remember, your period fluid is more than just blood! It also contains tissues, uterine lining, mucous and even blood clots. 

Here are a few questions to answer to see if your periods are too heavy:

  • Are you using more than one or two pads or tampons per hour, or more than six pads or tampons a day?
  • Do you have to double up on period products (using a pad and tampon at the same time or multiple pads at once) to control your flow?
  • Do you have to change your period products in the middle of the night because you’re worried about bleeding through?
  • Does your period usually last more than 7 days?
  • Do you have less than 21 days between the start of one period and the beginning of your next one?
  • Do you have period clots larger than the size of a quarter?
  • Is your flow so heavy that you can’t do the things you normally would, like attend school or participate in sports practice? Or do you experience frequent accidents where you bleed through your period products?
  • Do you feel tired or short of breath? 

 

Occasionally leaking through menstrual products or needing to change them in the middle of the night is a common experience. However, if this happens frequently during most of your cycles or if you answered yes to any of the above questions, it’s time to talk with your healthcare provider. They can help address your concerns, rule out any underlying health conditions that may be causing the heavy bleeding, and discuss treatment options. 

 

Works Cited 

 

  1. Heavy and Abnormal Periods | ACOG. Accessed September 6, 2024. https://www.acog.org/womens-health/faqs/heavy-and-abnormal-periods

2. Overview: Heavy periods – InformedHealth.org – NCBI Bookshelf. Accessed September 6, 2024. https://www.ncbi.nlm.nih.gov/books/NBK279294/