Every woman’s period is different, some lasting only a few days with a light flow, others lasting a week with a heavier flow, and everywhere in between. But you likely have a relatively similar flow each month. In some cases, it can hard to know whether you have what is considered to be heavy menstrual bleeding, also called menorrhagia. How do you know how much is too much?
What Is a Typical Period?
During a typical period, a woman loses approximately 60 milliliters of blood, which is enough to fill about one and one-half shot glasses, according to the U.S. National Library of Medicine. Your periods may be a little lighter or heavier than this. To be considered menorrhagia, doctors look for blood loss of about 80 milliliters or more.
How to Determine Whether Your Period Is Too Heavy
Because we don’t have a practical way of actually measuring our blood flow, it can be hard to know whether your period is “typical.”
However, there are signs you can watch for. For example, you can somewhat measure your flow by how many and how often you change your tampon, pad, or menstrual cup. According to the American Academy of Family Physicians, you may have menorrhagia if you:
- need to change your tampon or pad hourly or need to use a tampon and a pad together for more than a few hours
- you notice large or heavy clots
- have periods that last for more than one week
are excessively tired or lethargic during your period, which can be a sign of anemia from blood loss
find your amount of bleeding or pain from cramping interferes with your daily life or causes you to miss school or work
Younger girls frequently have irregular bleeding in the first few years after menstruation begins, according to a report published in 2008. This might make it difficult to determine if “heavy” bleeding occurs; however, the general rule of thumb is that if you need to change protection more than once per hour or wake up several times per night to change protection, you should be evaluated by a doctor.
What to Do If You Have Heavy Periods
There are several steps you can take if you think you have heavy periods:
- You may want to start by keeping a log of your menstrual flow for a few months. Keep track of how often you change your tampon or pad, how many you use during your period and how long it lasts.
Write down whether you have cramps and how many days the cramps or other symptoms, such as headaches, lasts.
Once you have tracked for a few months, make an appointment with your family physician or gynecologist, who may request some blood tests. In addition, you will probably have a pelvic examination. Your doctor will look for underlying conditions which may be causing your heavy periods, such as uterine fibroids, endometriosis, pelvic inflammatory disease (PID), and polyps on the lining of the womb.
Treatment for Menorrhagia
While treatment for menorrhagia is often not medically necessary, many women do want treatment to help alleviate the discomfort and the pain from cramping.
According to Johns Hopkins Medicine, some of the common treatments include:
Birth control pills to help regulate bleeding patterns
Anti-inflammatory drugs, which can help reduce flow and cramping
Endometrial ablation or resection, which is a surgical procedure to destroy or remove a portion of the uterine lining
A hormonal IUD, which often reduces menstrual flow and cramping
In more extreme cases, after childbearing is complete, a complete hysterectomy (surgical removal of the uterus) can be considered.
In addition to treatments specifically for heavy bleeding, you may need to be treated for secondary problems, such as being given iron supplements for anemia.