Your Menstrual Flow: What is Normal and Why it Matters…
If you’re a female who is not on an oral contraceptive or IUD - you’ll likely have monthly bleeding for many many years. This is a natural and important process but also puts women at a much higher risk of iron deficiency if the flow is heavy.
But what is heavy?
A normal menstrual flow should be:
Length: between 2-7 days long
Volume: between 20-50mL total
Consistency: Mostly liquid, a few clots are okay, but they shouldn’t be larger than a quarter.
Any cycle where you are losing more than 80 mL of blood would be considered heavy menstrual bleeding. This may be you if you are bleeding for more than 7 days, if you're passing large clots, if you're soaking through more than a pad or tampon an hour, or if you need to wake during the night to change menstrual products.
It can be really helpful to pay attention to the volume for a couple of cycles.
To track that accurately: A diva cup holds about 30 mL of fluid, a saturated regular tampon or pad will hold about 5 ml, and a super tampon or pad will hold about 12 ml. If you’re using period underwear or another menstrual cup or menstrual product, you should be able to find out the fluid volume online.
There are two reasons that it is valuable to track this.
A heavy menstrual flow (losing more than 80 mL in a cycle) will put you at a significant risk of iron deficiency. This becomes a vicious cycle because when you are iron deficient it makes it harder for you to clot, which then actually causes you to lose more blood - making the iron deficiency even worse.
There are underlying causes of menstrual blood flow that are important to understand as they can have impacts on your long-term health and should be monitored and/or treated. This may include thyroid dysfunction, PCOS, uterine fibroids, adenomyosis, polyps, clotting disorders and more.
It’s common during adolescence and in perimenopause to experience heavy menstrual bleeding, as during these times there will be cycles where ovulation does not occur so the uterine lining doesn’t have its normal maturation. While this is common and MAY be normal, we need to make sure there is nothing else going on, and that anemia is being properly assessed for and treated.
If this is you, and you’d like support with navigating heavy menstrual bleeding, I would love to support you with this! Book an initial HERE!