Quantifying your menstrual blood loss is no easy feat, depending on the kind of menstrual product you use and especially if you change your period product before it's fully saturated.
Most period products will list how much blood they can hold/absorb. This is a good place to start and approximate your blood loss.
For example, a cup or disc will tell you the volume you can hold. If you use a regular-sized pad or tampon, then each of those can hold around 5mL of blood.
Between 10 and 70mL of blood loss is considered normal. Most menstruators lose around 30 to 50 mL of blood over a full period (from start to end).
And, the typical length of a period is three to seven days, with most of the blood loss happening in the first 1-3 days.
Menstrual flow contains not only blood, but also tissue from the uterus, cells from the vagina, mucus from the cervix, and some of the bacteria that reside 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.
