How about your menstrual flow ?

Is Your Menstrual Flow Too Heavy?

It's not always easy to know how much menstrual bleeding is normal. These tips will help you know when you need an ob-gyn's opinion.

By Charlotte Libov

Medically reviewed by Cynthia Haines, MD

When you get your period, it may seem like a lot of blood loss. But because it’s impossible (or at least impractical) to actually measure your menstrual flow, it can be hard to know whether yours falls within what’s considered a normal amount — or if it indicates heavy menstrual bleeding, called menorrhagia.

“Very often, women do not realize that they are having heavy bleeding because it’s a normal amount of blood for them,” says Viviane Connor, MD, a gynecological surgeon at Cleveland Clinic Florida in Weston, Fla. “But it’s notnormal. I’ve seen women come in very, very anemic, with a low blood count, because they are flooding — they are very nearly hemorrhaging.”

Though open to great variation, the “average” period occurs every 28 days, lasts about 4 days (plus or minus 2 or 3), and produces a total blood loss of about 2 to 3 tablespoons. But when it comes to heavy menstrual bleeding, the amount of blood lost is not as important as the impact on the woman’s life, says Dr. Connor.

“A normal menstrual cycle does not interfere with a woman’s ability to function normally," she explains. "If she’s concerned about having to run to the bathroom frequently or if she’s experiencing a lot of pain or discomfort, that is not normal."

The Signs of Menorrhagia

These are the signs and symptoms of a heavy period:

• Your period lasts more than seven days.
• You go through more than six or seven tampons or pads a day.
• You are losing so much blood that you become anemic. (Anemia is a condition that occurs when your blood does not have enough iron, making you tired.)
• You get painful menstrual cramps. Heavy bleeding can cause the uterus to contract, which causes cramps.
• You get menstrual blood clots. Although, clots smaller than the size of a quarter are normal.

Women can experience heavy menstrual bleeding at any age, but it may occur more often as you near menopause and begin to skip periods — so when you do bleed, the flow may be heavier than normal.

Next Steps When You Have Heavy Menstrual Bleeding

If you find that your life is put on hold once a month because of your period — you’re constantly worried about leaking through your pad, or cramps have you doubled over — schedule an appointment with your primary care doctor or ob-gyn. There are many causes of heavy menstrual bleeding, ranging from hormonal imbalances to uterine fibroids, which are noncancerous growths that can appear during childbearing years. Heavy bleeding can also be effectively treated, even if there isn’t an underlying medical condition causing it. Treatments include over-the-counter medications, hormonal treatments like low-dose birth control pills, and nonhormonal medications.

However, many women are not aware that there are options for heavy periods, and some even avoid discussing it with their doctor out of fear or embarrassment. But there’s no reason to put your health on the back burner or your lifestyle on hold because of heavy menstrual bleeding. Talking openly with your doctor will get you the answers you need and the treatment to manage your heavy periods — so you can stop dreading that time of the month.

Last Updated: 12/14/2011

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