Menorrhagia – doesn’t that word sound like some crazy illness or disease?
Like, “Whoa, you have menorrhagia, that could be serious girl!”
Menorrhagia is in fact, just the fancy term for “heavy periods”, which aren’t exactly life threatening, but can put a serious damper on life activities!
I used to have horribly heavy periods when I was younger, which was part of the reason I went on birth control. I remember years ago I was in Grand Central Station in New York, and I was rushing to catch a train. I was using a super tampon AND a pad, and within thirty minutes I was flooding through both of them. It was horrific. I ended up missing the train because I spent so much time in the bathroom trying to sort myself out!
I also remember being in high school and literally praying every month that my period wouldn’t leak through my uniform. I’d wear a tampon, pad, undies and boy shorts under my dress! It was bananas.
I figure you might be able to relate to these stories? If so, keep on reading!
What is a normal vs a heavy period?
Normal periods are defined as vaginal bleeding that occurs every 25-35 days, and lasts for 3-7 days, with an average blood loss range of 30-5o milliliters. Each soaked regular pad or tampon holds roughly 5ml of blood, so it’s totally fine to soak 6-10 pads/tampons during each period.
If your period lasts longer than seven days and you’re losing more than 80 ml of blood per cycle, or you’re soaking more than 16 regular tampons or pads per cycle, then this is a sign of a heavier than average flow (menorrhagia). Other signs are flooding (like I described above) and clots that are the size of a quarter or bigger.
FYI – 80 milliliters equals about 5.5 tablespoons or 2.7 liquid ounces, or 16 soaked regular pads or tampons.
Another FYI – as always, it’s really important for you to determine what is normal for you. All these numbers are merely statistics based on the experiences of a small group of women, and don’t necessarily represent your body’s norm.
In this post I share what your period is really supposed to look like.
Calculate how much you are bleeding
So one soaked regular tampon or pad holds 5ml or 1 teaspoon of blood and a fully soaked super tampon holds 10ml. A half soaked regular pad or tampon equals 2.5 ml and a half soaked super tampon holds 5ml.
Make a note in your period tracking app every time you change your pad or tampon in a 24 hour cycle to determine if you have a heavy period. If the number of fully soaked or half soaked pads or tampons in any given cycle is more than 16, then you have a heavy flow.
What does a heavy period look like?
Women often describe heavy periods as a major disruptor in all areas of their lives. From work, to dating, to the beach and exercising – a heavy flow can feel really unmanageable. Women complain of constantly worrying about embarrassing leaks or accidents, ruining underwear and favorite outfits, stressing about simply leaving the house or doing normal activities, and the fatigue that comes with excessive blood loss.
Here are some physical signs of a heavy period:
- Your period consistently lasts more than 7 days.
- You’re changing tampons or pads more than every 2 hours each day
- You need a pad and tampon to control your menstrual flow.
- You have to change your pads or tampons during the night.
- You have a menstrual flow with blood clots the size of a quarter or larger.
- You experience tiredness, you lack energy, or you are short of breath, or you’ve been diagnosed with anemia.
What makes a woman have a heavier period?
Heavy bleeding can occur at any age, but it is most common on either end of the reproductive age spectrum, during the teenage years and then again during perimenopause, when estrogen levels tend to be higher in relation to progesterone.
Progesterone is made in the ovaries after ovulation occurs. These two time periods are characterized by irregular ovulation:
- Adolescents experience heavier periods likely because of the immature endocrine system, in particular, the immature hypothalamus function. (The hypothalamus talks to the ovaries and tells them when to ovulate, so if it’s still developing, there are likely to be hiccups in the system). In addition, estrogen receptors a very sensitive to estrogen (because they are still figuring things out) and will become less sensitive over time.
- Perimenopausal women experience heavier periods because of waning ovarian function – as the ovary ages, it is less likely to complete the ovulation process.
Why do I have a heavier than average period?
The causes of heavy periods and the related conditions to heavy periods fall into three categories:
Heavy periods can be caused by hormonal imbalances:
- A period that is heavy, dark, clotted, clumpy, or looks like frozen crushed up blueberries, is indicative of higher estrogen levels. Estrogen is a proliferative hormone, responsible for stimulating the growth of the uterine lining and breast tissue. Breast tenderness, stubborn weight, acne, PMS, headaches or migraines can result from too much estrogen in relation to progesterone, which is known as estrogen dominance.
- You can test your estrogen levels with this Female Hormones at home test kit (use code Hormones20 to get 20% off all tests at Lets Get Checked).
- Another imbalance that may contribute to heavier flow is low thyroid function, or hypothyroid. Thyroid hormone and progesterone are intricately connected – if your body is not producing adequate thyroid hormone, your progesterone levels may drop as well, causing estrogen to become dominant over progesterone. And, hypothyroid also causes poor estrogen detoxification.
- This Thyroid Test will provide a complete picture of how your thyroid is performing (use code Hormones20 to get 20% off all tests at Lets Get Checked).
Uterine problems can lead to heavy periods:
- Endometriosis and Adenomyosis
- Uterine fibroids – interestingly fibroids don’t actually cause heavier bleeding, but they are related to heavy bleeding because high estrogen/low progesterone causes both fibroids and heavy bleeding. Fortunately, the type of fibroids that cause heavy bleeding (submucus fibroids) only account for 5-10% of all fibroids.
- Polyps – these can cause abnormal bleeding, but it is not usually heavy.
- Miscarriage, ectopic pregnancy or postpartum.
- Some illnesses, diseases or medications can cause heavy periods:
- Medications like the depo provera shot, as well as the Paragard (copper) IUD.
- A bleeding disorder known as von Willebrand disease – known as a coagulopathy, this condition is associated with problems in how the blood clots. Twenty percent of adolescent girls with severe menorrhagia have a blood coagulation problem.
- Liver, kidney and pelvic inflammatory disease.
Note: Endometrial cancer may cause irregular bleeding in the form of spotting, but it is not a cause of heavy bleeding.
How does your menstrual flow change over the course of your life?
Your menstrual cycle and flow definitely change throughout the course of your life. There are four distinct stages of the menstrual cycle throughout a woman’s lifetime.
- Puberty that brings on a girl’s first period, and includes the teenage years
- Adult menstruation stage
Each of these stages brings about varying hormonal fluctuations and accompanying symptoms. Most teenagers have a heavy flow when they first get their periods because of higher estrogen, but that usually regulates as a girl gets older.
Diet (including caloric intake), exercise, hormonal contraceptives, pregnancy, miscarriage and birth can change a woman’s hormones and flow significantly throughout her life.
Women in perimenopause tend to have heavier flow because this is when ovulation starts to sputter, which lowers progesterone. This leads to estrogen becoming dominant again and increasing flow. Some women even experience flooding during perimenopause.
Read about five surprising things that can disrupt ovulation other than perimenopause.
Is having a heavy period a sign of being less fertile?
Not necessarily, but it can indicate an underlying hormonal imbalance that could negatively impact a woman’s fertility. The two hormonal imbalances linked to heavier flow are high estrogen/low progesterone and low thyroid function, as I mentioned before.
Healthy, regular ovulation is crucial for having optimal fertility, but it can’t happen if your sex hormones and your thyroid are out of whack. The right amount of progesterone is critical for implantation of a fertilized egg because it keeps the uterine lining intact. If there isn’t enough progesterone, it can lead to a shortened luteal phase (the second half of the cycle after ovulation occurs), which can prevent implantation from happening. A luteal phase should be a minimum of 10 days, and ideally should be 12-16 days long.
Low thyroid function can mean lower body temperatures, which can affect a growing embryo because it needs to be at a certain temperature in order to grow and develop.
Does a heavier period mean worse PMS symptoms?
The two are often linked because of the estrogen dominance/low progesterone imbalance. Too much estrogen and too little progesterone can lead to increased emotional and physical PMS symptoms. Progesterone is the feel-good, keep calm and carry on hormone, and when it’s low during the second half of the cycle, you may suffer from anxiety, anger, low mood disorders like depression, mood swings and snappiness, bloating, breast tenderness, and acne.
Is your period heavier after you lose your virginity?
No, losing your virginity or having sexual intercourse for the first time does not have an impact on your period flow. However, regular sexual intercourse does have an impact on your sex hormones, and can actually make your period come more consistently!
Why is it recommended to use the lightest tampon you need for that day?
It is recommended to use the lightest absorbency tampon because conventionally-made tampons contain a whole host of chemicals like dioxin (which is a byproduct that comes from the chlorine bleaching process), and pesticides that have been sprayed on the cotton.
FYI – cotton is one of the most heavily sprayed with pesticides. You do not want these chemicals anywhere near your vagina, much less in it for long periods of time each month when using tampons.
Additionally, most conventional tampons are made with a blend of cotton, rayon, and wood pulp. Yes, you read that right! Rayon tends to absorb not only menstrual blood but your natural vaginal fluids as well, leaving your vagina dry and irritated in many cases. Finally, your vaginal tissue is the most permeable tissue in your body, which means it is especially vulnerable to chemicals and toxins.
Organic tampons are the way to go! There has not been one case of TSS with the use of 100% organic cotton tampons. I recommend Maxim Hygiene Organic Tampons, Cora Organic Tampons (with BPA free plastic applicators), and Lola Organic Tampons. Or try a menstrual cup, pads, or period underwear instead.
Testing and recommendations for heavy periods
Please see your doctor if you are experiencing any of the symptoms I described.
- She will want to do a pelvic exam to determine if there are any physical issues. This should also include a pelvic ultrasound to check for fibroids and endometrial thickness.
- I would also recommend a full thyroid panel, a pap smear, a pregnancy test, STI testing, and a complete blood count to determine if you have anemia. You can also do these test from home at Lets Get Checked. Use code Hormones20 to get 20% off all tests.
- There may be a need for other procedures like an endometrial biopsy, to determine the presence of endometrial hyperplasia, uterine cancer or infection. Or a SIS (saline infusion sonohystogram) to get a 3D view of the uterine cavity
The conventional treatments for heavy periods include the birth control pill (I don’t recommend that!), Mirena IUD (progesterone-releasing), D&C (Dilation & Curettage) to remove the uterine lining temporarily, endometrial ablation and hysterectomy (these last two are permanent so if you want kids, they are not for you).
Natural treatments for heavy periods
- Vitamin A – from liver or cod liver oil preferably. I like Rosita Real Food Cod Liver Oil or Cod Liver Oil Capsules. Vitamin A deficiency has been found in women with menorrhagia and vitamin A supplementation has been shown to reduce heavy periods significantly.
- B Complex – The liver does not metabolize estrogen effectively if a woman is deficient in the B complex vitamins. Supplementing with the B Complex will help restore the proper metabolism of estrogen in the body. I like Thorne Research Basic B Complex.
- Vitamin C – Vitamin C may reduce heavy bleeding because of their anti-inflammatory effect. Vitamin C is also important in preventing and treating anemia because it helps improve the absorption of iron, which might also be why it works for reducing heavy flow. I like Livon Labs Lipospheric Vitamin C or Seeking Health Optimal Vitamin C Powder. 2000-4000mg a day.
https://www.ncbi.nlm.nih.gov/pubmed/27884916 – conventional treatments for menorraghia
https://www.ncbi.nlm.nih.gov/pubmed/27841443 – additional conventional treatments
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2077876/ – natural treatments
https://www.sciencedirect.com/topics/medicine-and-dentistry/menorrhagia – Vitamin C and bioflavonoids
14 thoughts on “Everything you ever wanted to know about heavy periods”
Dude im 14 and like my periods are ridiculous like when i wake up i have to run the fastest i can to the bathroom because none of the nightpads ive found are thick enough its really annoying having to wash so many panties i was at the nurse to have a check up i wore a tampon and a pad the thing was 40 minutes long and i had to run home hoping no one would notice my bloody pants (im thankful my mom bought a long jacket for me otherwise I wouldn’t have made it without dying from embarrassment) i dont know what to do my mom told me “ah maybe we have to buy some pills” , i found this really late .-. 2019… but i hope me leaving this comment wont be weird or anything
I’m getting to my wits end and I really could do with some practical advice I’m 32 up until 30 I had normal to heavy periods I’ve had 3 miscarriages and have become very overweight for the last 2 years I’ve been either not bleeding or constantly bleeding I’ve had ultrasounds, endometrial biopsies , blood tests all come back normal I have been told that the mini pill is not an option due to my weight and now the coil is my only option I have had to beg for a sick note as I am currently using incontinence pads as sanitary wear is not enough – my plea / question is will the coil work and how quickly and how do i leave my house in the mean time I managed 20mins yesterday any advice would be gratefully received
I’ve had a horrible time! I started when I was around 15/16 and recall them being heavy and emtionally draining and traumatising. After meeting my now husband I went on the minipill around 17/18 which was the best thing I ever did as it got rid of ‘it’ all together. Now 8odd years later, married and thinking about kids, I stopped taking the pill. Worst choice I could have ever made. Within a hour I had filled a mooncup and a maxipad at the same time!! It will not stop, and today I blackout and collpased! So now on a clotting tablet and iron tablets and bed rest, I cannot stand for more than 2mins, my life is hell and I have been told to go back on the pill which dam right I will and will happily take for the rest of my life so I can actually live my life
So,if the fibroids are submucosal, are you saying that balancing out the hormone levels, low D, low B will not help?
No, not saying that at all, and not entirely sure how you came to that conclusion. 🙂 Regardless of the type of fibroids, you 100% want to address hormonal imbalances, and the causes of those imbalances.
“fibroids don’t actually cause heavier bleeding…high estrogen/low progesterone causes both fibroids and heavy bleeding…fortunately, the type of fibroids that cause heavy bleeding (submucus fibroids) only account for 5-10% of all fibroids.”
Well, yes, agree on balanced hormones regardless. 🙂 I came to that conclusion because you stated fibroids don’t cause heavier bleeding unless they are submucosal which account for 10% or less of all uterine fibroids. I’m trying to understand if even with balanced hormones a woman with submucosal fibroids will still experience heavy bleeding because it sounds like those types of fibroids cause the bleeding, not the imbalanced hormones. In your studies or work with women, have you found this to be the case? Thank you for the help.
Ah right, I see what you’re saying. We have to look at what is feeding the growth and development of the fibroids – is it elevated estrogen, or estrogen metabolites. Why is that happening? Is it from our gut bacteria? Is it from compromised liver function. Are we exposed to a lot of environmental chemicals that are estrogen mimickers?
Fibroids are tough because once they are there, it’s quite difficult to shrink them. So it would make sense to get your hormones into a good place, and see how that impacts your fibroids. But yes, once your estrogen/progesterone are more balanced, then the next step would probably be surgical if the fibroids haven’t shrunk and/or you still experience symptoms. I hope I am making sense! 🙂
Let me know if that helps. xo
Dear Nicole, I came across your podcast on Cycles and Sex on instagram today. I had very painful/heavy periods as a teenager. I got on birth control pills in my 20s for about 7 years. I had 2 children in my early 30s. And afterward used the ring for birth control. My husband got a vasectomy about 5 years ago, and I got back to my regular cycle which was very heavy, painful, clotty, and headachy. My mother got breast cancer then ovarian cancer. I am almost 47 and am having a hysterectomy tomorrow to reduce my chances, which are very high, of getting ovarian cancer. My doctor wants to give me an estrogen cream to rub on my forearm for a few weeks for managing menopausal symptoms. Do you have any advice for me? I want to keep my cancer risks as low as possible, thus am concerned about taking estrogen. I’m guessing from listening to you/reading your stuff that I have always been estrogen heavy to begin with. I do not drink alcohol or eat processed food.
I would so love to offer you advice, but hormone replacement therapy is outside of my scope of practice as a health coach. I would strongly recommend you find a doctor in your area who is trained in HRT, specifically bio-identical hormones. What you really want to be looking at for your own health is how your body is detoxing estrogen. I know you’re scheduled for a hysterectomy but it will still help your health in the long run. Take good care of yourself!
This was really helpful. A tad disheartening to learn that because of a heavy period I might have trouble conceiving….I know it’s a “might”, but the one solace I always said to myself having a heavy period since I was 14 was that: “at least I’m ridiculously fertile.”
I will take the suggestion for a doctors visit. I found it super comforting to read that more intense pms, clotting, and stubborn weight are all normal for someone with a lot of estrogen. I’ve always said these things are “because of my period”‘ and I’m pretty damn pumped to figure out how to balance everything out.
Our NFP journey has been interesting because my body temp runs low, BUT a year ago my thyroid bloodworm came back negative.
So much to keep learning and understand.
That info about tampons just gave me the final push to get over it and try the diva cup that has been sitting on my shelf.
Thanks for all of this info!
If you ever do consults, please contact me!
Aubrey! Don’t be concerned about conceiving. Lots of women with heavy periods conceive easily and naturally. So just focus on that 🙂 The only reason I said it is because they are often a sign of an estrogen/progesterone imbalance, which can be problematic for conception, but not always. And keep in mind if you saw a conventional medical doctor then your thyroid results are potentially inaccurate. Functional medical testing is the way to go, especially with thyroid because their ranges are much narrower than conventional ranges. My assistant will reach out to you to discuss a consult. xo
Yep . Me – Super heavy periods for years – no problem conceiving at all , happened very quickly at age 35.
My periods only became a problem after I had my tubes clamped about 9 yrs ago 3 months after my youngest son was born, until then my periods were pretty normal now they are heavy (flooding nightly, changing my pad every two hrs or less with clots and very painful irregular Your site has given e a lot of information I have been told I am perimenapausal but had no test to confirm this .
Hi Mandy! Thanks for your comment and I am glad my site has been helpful for you. Can you get in to see a doctor for hormone testing to determine your hormonal baseline? I think it’s so necessary to figure out the issue, especially since you’ve had it for so long and you could be in perimenopause for another 5-10 years depending on your age.
Based on what I know, anovulatory cycles after getting your tubes clamped can cause these period problems. When you don’t ovulate your sex hormones will get out of balance, causing heavy painful periods for some women. You can reverse the procedure (again, you need to go see someone about this), and you will potentially solve these problems you’re having. So consider doing some research to find out about solutions for you based on the fact that the clamped tubes could be the problem and need to be addressed.
Hope this helps!