How much blood is too much blood? Women aren’t taught what a normal period looks like. Menstrual cycles are private, and it can be so easy to think that soaking through a tampon every hour is just the way your body works. But that is not the reality
Are heavy periods normal? If you are bleeding heavily occasionally, this is normal, but if you are bleeding heavily all the time, your body requires medical investigation. In medical terms, heavy periods are called menorrhagia, and it affects one in five women.
The typical menstrual cycle loses between 30 to 40 milliliters of blood. Menorrhagia is confirmed by clinical diagnosis if your blood loss is more than 80 milliliters per cycle. Your doctors use actual real signs to determine what is happening with your body.
Menorrhagia – Medical Term for Heavy Periods
Menorrhagia is the medical term for heavy or prolonged menstrual bleeding. It is defined as bleeding that lasts longer than seven days.
More recent clinical literature also uses the term heavy menstrual bleeding (HMB). This new term has largely superseded the previous term, menorrhagia, because it is more descriptive and more easily understood by the patient.
Clinically, it’s defined as:
- Losing more than 80ml of blood per cycle
- Bleeding that occurs for more than 7 days.
- Needing to change your pad or tampon every 1-2 hours
- Passing clots larger than a quarter
- Recurrent bleeding that will penetrate clothing or sheet
There’s no need to measure your bleeding in milliliters to feel like something is amiss. If you find you are being controlled by your period, then that’s your answer.
Are Heavy Periods Normal?
A few days of heavy period is normal. But if your period is heavy every month then it can be a problem.
A normal period typically involves:
- 21-35 day cycle length
- 3-7 days of bleeding
- Total blood loss less than 80ml
- Manageable cramping
- No large clots
One thing that is always forgotten: if your periods have been heavy since your first period as a teenager and nobody ever pointed out that, that doesn’t mean that period was normal. It generally means it simply wasn’t investigated. Adolescent menorrhagia is one of the most frequent initial symptoms of a bleeding disorder.
When is a Heavy Period Harmful?
Excessive bleeding is bad for the body. Iron is important to your body because it produces hemoglobin, a protein that carries oxygen to your cells.
Heavy monthly bleeding causes loss of iron stores. This results in iron deficiency anemia over time. You have anemia when you feel dizzy, weak and completely exhausted during periods.
You should pay attention to these physical symptoms:
- Soaking through a pad or tampon every hour
- Wearing two layers of protection
- Bleeding for more than 7 days
- Regular bleeding into clothes or sheets of paper
- Getting up from your bed at night to change your pad
- Pale skin
- Brittle nails
- Hair loss
- Fatigue
- Dizziness
- Shortness of breath during your cycle
- Pelvic pain
When It is a Medical Emergency:
- Using a super pad or tampon every hour for 2+ hours
- Passing large clots
- Very dizzy when standing up.
- Fast heart rate and lots of blood loss
- Severe anemia symptoms such as shortness of breath, chest pain and confusion at rest
What Causes Heavy Bleeding During Periods?
Estrogen and progesterone are both important hormones for your menstrual cycle. These are the most common drivers, exactly what they really look like, and why they occur.
1. Hormonal Imbalance
Your uterine lining (endometrium) builds up in response to estrogen and sheds in response to progesterone dropping. When estrogen is in excess of progesterone, it is called estrogen dominance. It will cause your lining to turn thicker than needed. Thicker lining causes heavy periods with clots when it sheds.
This imbalance is seen in conditions like:
- Perimenopause
- PCOS
- Chronic stress
- Poor liver detoxification of excess estrogen
- Anovulatory cycles where you don’t ovulate
2. Thyroid Dysfunction
There’s a strong link between your thyroid and your period. Heavy bleeding is especially associated with hypothyroidism. Another study revealed that women with hypothyroidism had a significant number of menstrual irregularities, such as menorrhagia.
If your periods got heavier at the same time and you began to feel cold all the time, gain weight, lose some or go extremely tired, have your thyroid checked. TSH is not sufficient, you should also request Free T3, Free T4, and thyroid antibodies.
3. Fibroids
Uterine fibroids are non-cancerous growths in or on the uterus. They are very frequent, occurring in as many as 70-80% of women by the time they reach age 50, but not all women will experience symptoms from their fibroids.
Fibroids that are growing into the uterine cavity (submucosal fibroids) are the most likely to cause heavy bleeding. This is because they expand the surface area of the uterine lining and disrupting the uterus’s ability to contract and stop bleeding effectively.
4. Adenomyosis
Adenomyosis occurs when the lining of the uterus expands into the muscle wall of the uterus. It is associated with heavy, panful periods; and is frequently misdiagnosed as bad cramps for years. It is more prevalent than you think.
5. Polyps
Endometrial polyps are small growths typically found in the lining of the uterus and usually are not cancerous. They can lead to spotting between periods and heavy periods, particularly if they are large or frequent.
6. Bleeding Disorders
Von Willebrand disease is the most common inherited bleeding disorder. It is very under diagnosed in women with heavy periods.
Study found that a many women with menorrhagia in whom no other cause was identified screened positive for some underlying bleeding disorder. Heavy periods, easy bruising, nosebleeds, excessive bleeding after dental work or minor cuts and a family history of heavy periods are the common clues of bleeding disorders.
7. Copper IUDs
It is free of hormones, making it a popular option for many women. But its one side effect that has been documented is heavier, more painful, periods, especially during the first few months after it is inserted.
If your heavy bleeding began immediately after you were inserted, this is probably your answer. If it is having a significant effect on your life, it’s worth talking about alternatives.
8. Nutrient Deficiencies
Heavy periods and iron deficiency are co-related. Heavy periods lead to low iron levels, and low iron may make periods heavier as it can impair uterine contractions and clotting.
In some studies, treating iron deficiency alone has resulted in a mild decrease in blood loss without other treatment.
Heavy Periods with Clots
Heavy periods that come with the presence of clots occur when the blood becomes stagnant in the uterus and the body’s natural anticoagulants are not able to thin the blood and allow it to flow properly. If bleeding is severe, the blood can accumulate in the uterus and vaginal canal before the enzymes working to prevent it. The blood begins to clot before it exits the body, which is exactly what you see when you pass a clot.
Occasional small clots (smaller than a dime) are usually normal, especially on your heaviest day. But pay attention if you see:
- Clots larger than a quarter consistently
- The blood clot is accompanied by pain
- Clots on several days (not just your heaviest day)
- Heavy clots with severe tiredness
If this sounds like you, it’s worth getting checked. Book a Women’s Health consult with Kairos today!
Finding the Heavy Periods Root Cause
Typical physicians prescribe birth control pills or hormonal IUD to alleviate heavy periods. They are used to artificially delay the bleeding, or to halt the natural bleeding process. This simply addresses the symptom and will not really treat the underlying cause of the heavy periods.
A functional provider will carry out specific tests to find out what is going wrong:
- Complete hormone panel: Testing of both estrogen and progesterone and also testosterone levels during the cycle will help determine where the imbalance is occurring.
- Complete thyroid panel: This involves checking TSH, free T3, free T4, and thyroid antibodies to rule out a thyroid issue.
- Comprehensive Iron Studies: Checking hemoglobin only shows anemia after it has already happened. Functional providers screen for ferritin, your iron reserve, to get a head start on detecting when you are iron deficient.
- Inflammatory Markers: High inflammation can drive estrogen dominance, which directly causes the uterine lining to overgrow.
- Stress patterns and Cortisol levels: Chronic stress has an impact on the same pathways with regards to your cycle. Fixing the chronic stress can actually be the part of the cure.
All of these tests are not rare. It’s regular labs, but conducted with more purpose and evaluated with more background than a five minute visit.
Home Remedies to Stop Heavy Bleeding During Periods
Testing and appointments may take a few weeks to determine the cause of the problem. There are some natural ways that can help your body and decrease the blood flow.
Yarrow Tea: Natural astringent compounds are found in yarrow. Yarrow tea will constrict blood vessels and decrease excessive blood flow.
Shepherd’s Purse: This is an herbal remedy known to help the blood clot properly and reduce uterine bleeding. It is available in tincture form at most health food stores.
Eat Iron-Rich Foods: If you are bleeding heavily, you must replace what you lose. Consume grass fed red meat, liver, spinach and cooked beans. These should always be eaten with foods rich in vitamin C (citrus or bell peppers) to significantly boost iron absorption.
Seed Cycling: Take a tablespoon of ground flax and pumpkin seeds per day for the first half of your cycle. This can help to control natural estrogen levels, and stop it from getting too thick in the first place.
Steer clear of Ibuprofen: NSAIDs may temporarily decrease flow, but over time cause damage to the lining of the gut and increase systemic inflammation. This inflammation, over time, actually causes periods to be heavier.
Avoid inflammatory foods during a period: Too much sugar, alcohol and processed seed oils are known to raise prostaglandins, which can lead to heavier bleeding and cramping.
Add Magnesium: This helps to balance prostaglandins and may relieve cramping that sometimes occurs during heavy flow.
Eat more omega-3 fatty acids: This, found in fish oil, can help balance the prostaglandins that contribute to heavy, painful periods.
Ginger: Ginger tea could decrease the amount of blood lost during menstruation, perhaps by its effects on prostaglandins.
A heating pad: This may alleviate cramping and provide comfort, but won’t lower blood loss..
The Bottom Line
Heavy periods are normal. Many women have it. Normal means it’s how your body is supposed to work
If your period is taking up your time, causing you to feel drained and making you think “this is more than just a heavy day,” it’s a signal your body is sending you. The cause is typically identifiable and once identified, is typically treatable.
Lola, one of our functional health providers, will take the time to look at advanced labs to find the true root cause of your bleeding and build a personalized plan to stop the heavy flow.
At Kairos Health & Wellness
We consider all aspects of heavy periods, including hormones at correct times, full thyroid function, iron status (ferritin), and the bigger picture of stress, metabolic health and liver function that often ties them together.
If you have had heavy periods and no one has ever asked you why, that’s the question we are here to assist you with!