It can be hard to figure out how much blood you're losing during a period, especially if you're using more than one product, leaking through them, and/or using different kinds of sizes for each day of flow.
Many period products will say how much approximate fluid they can hold.
Commercial absorbent products (one-use pads and tampons) usually use these descriptors and parameters:
If you use a cup or a disc, there should be volume markings on there. Or, perhaps, the packaging will tell you how much it holds.
If you use period underwear or another product, those should tell you as well; however, period underwear claims tend to overestimate the quantity of blood they can hold. Depending on the feel and colour (which is usually dark), it can be really difficult to say how much blood you're actually looking at.
On average, menstruators lose 30-50 mL of blood over 3-7 days.
Those are averages. Some people might naturally sit a bit beyond that.
Period flow contains lots of things like uterine tissue, cells from the vaginal wall, secretions from the vagina and cervix, and some of the bacteria that live in the reproductive tract.
Rarely, you may even shed a big membranous tissue called a decidual cast. This happens when the uterine lining is shed intact instead of in little bits.
Heavy or prolonged menstrual bleeding can be called abnormal uterine bleeding. This is when period flow volume goes >80mL over a whole period OR when bleeding goes beyond 7 days.
You should really discuss this with your healthcare team because it could be indicative of a new development (like a fibroid, polyp, endometriosis, adenomyosis, anovulatory cycles, clotting disorders, etc.).
Now, you might have the odd time when your bleeding increases in volume, for example, if you took emergency contraception, if you had a missed early pregnancy loss, if you had an anovulatory cycle, etc. If it happens once or twice and resumes to its normal, then maybe it was simply a transient change in your hormones. However, if it lasts, then definitely get some testing (bloodwork and imaging) to understand what's happening. Heavier bleeding is often seen in the menopause transition as hormones fluctuate irregularly and ovulation tends to be erratic. This doesn't mean that you go without support if your bleeding is affecting your quality of life!
You might also be within the normal reference range for blood volume, but it's a significant increase for you. For example, if you always bled 30mL but now are bleeding 60mL per period, that's twice as much blood loss even though it's within that 70mL reference range. This is still something to investigate with your docs.
Heavy bleeding signs can include anaemia, large blood clots (over 2.5cm), changing or flooding through your period products, and/or fatigue.
Well, that depends on what's going on, what you've tried, and what your goals are (for e.g., we might support you differently if you're trying to conceive vs. if you're approaching menopause)! There are many conventional and naturopathic options including medications, IUDs, herbs, nutrients, acupuncture, and more to help you out. If you're in Ontario and looking for naturopathic support, I'd be happy to support you in your journey.
