It’s a common question that often is asked on HealthCentral’s menopause site - What’s a normal period when you’re going through perimenopause? That’s because some women report that their periods are lighter and may just involve spotting while others describe extremely heavy periods. And some women miss a period and then experience a heavy period.
It turns out that irregular periods are normal. "In the years preceding menopause, women experience changes in their menstrual cycle," HealthCentral.com stated. "The time between periods can become shorter or longer and periods may last a longer or shorter number of days. Bleeding can be heavier or lighter, and change in flow from month to month. It is also normal for periods to skip a cycle."
In their book "The No-Nonsense Guide to Menopause," Barbara Seaman and Laura Eldridge note that hormone fluctuations cause these changes. "Specifically, it seems that when the amount of estrogen in the body is significantly disproportionate to the amount of progesterone, floods happen," they write. "Actual floods - the weather kind - happen when the atmosphere is out of balance: a low-pressure system bumps up against a high-pressure system and boom, thunder and rain ensue. The same is true with the body. This may be one reason why heavy bleeding is more common at the end of the menopause transition."
Part of the difference may be where you fall in the timeline for "the change" (as my mother’s generation called it). HealthCentral.com described the stages of menopause as:
- "Early Stage. Perimenopause can begin in some women in their 30s, but most often it starts in women ages 40 - 44. It is marked by changes in menstrual flow and in the length of the cycle. There may be sudden surges in estrogen."
- “Late Stage. The late stages of perimenopause usually occur when a woman is in her late 40s or early 50s. In the late stages of the menopausal transition, women begin missing the periods until they finally stop.”
Seaman and Eldridge cited research that found that the average period of a premenopausal woman lasts between 4-6 days, during which she will have lost a total of between 10-35 milliliters of blood. Obviously, going through perimenopause causes a woman’s periods to get out of whack. However, Seaman and Eldridge suggest that if you’re losing more than 60 milliliters, then you may want to consult your doctor.
To determine how heavy your period is, you need to keep track of the number and types of sanitary products that you use and then multiply by the amount of flow (listed below). Tracee Cornforth wrote on About.com that the United States Federal Drug Administration has developed the following standards for tampons:
- Light absorbency tampons absorb 6 grams of blood or less.
- Regular absorbency tampons hold from six to nine grams.
- Super absorbency tampons hold from nine to 12 grams of menstrual blood.
- Super plus absorbency tampons can absorb between 12 to 15 grams of blood.
- Ultra absorbency tampons absorb from 15 to 18 grams of menstrual blood.
Sanitary pads are rated the following, according to the Feminine Hygiene Resources Center:
- Panty Liner - Designed to absorb daily vaginal discharge, light menstrual flow, “spotting”, slight urinary incontinence.
- Ultra-thin - A very thin (compact) pad, which may be as absorbent as a Regular or Maxi/Super pad but with less bulk.
- Regular - A middle range absorbency pad. Most used by the women.
- Maxi / Super - A larger absorbency pad, useful for the start of the menstrual cycle when menstruation is often heaviest.
- Night - A longer pad to allow for more protection while the wearer is lying down, the size is little longer than regular pad, Night pads with an absorbency suitable for overnight use.
Seaman and Eldridge point out that a normal-sized sanitary pad can hold approximately 5 milliliters of blood whereas a supersized pad can hold about 10 milliliters.
Dorian Martin writes about various topics for HealthCentral, including Alzheimer’s disease, diet/exercise, menopause and lung cancer. Dorian is a health and caregiving advocate living in College Station, TX. She has a Ph.D. in educational human resource development. Dorian also founded I Start Wondering, which encourages people to embrace a life-long learning approach to aging. She teaches Sheng Zhen Gong, a form of Qigong. Follow Dorian on Twitter at @dorianmartin, Facebook or Instagram at @doriannmartin.