Women often agonize about their periods being TOO long but there are many of us (myself included at one point) who have periods that are too short. So, how long should your period be?
When I came off the pill in my early 20’s, my period had gone from 5 medium/heavy days to 1 very light day. While on the pill, my diminishing period seemed like the best thing ever but the health consequences of a practically non-existent period soon became glaringly obvious.
Think chronic yeast and urinary tract infections, headaches, constant colds, joint pain, low sex drive, awful stomach problems, skin problems etc etc etc! :-/
I had no idea what was going on in my body but in a nutshell, my sex hormone production was slowly shutting down (thanks to no ovulation) and with every month that I spent on the pill I was producing less and less estrogen, progesterone and testosterone. Add to that a high stress college environment, internships and job searching and it was a recipe for disaster.
So I’m going to start with the causes and solutions for short periods but if you’re experiencing long or heavy periods, then you can click here to skip to that section of this post.
So, what are the causes of a short period?
Most of the time, a 1-2 day period is linked to low estrogen. When there isn’t enough estrogen to build the uterine lining, you inevitably end up with periods that are very light, pinkish in color (rather than a vibrant red color) and too short.
If you’ve been following me for even a short time, you know that I am a huge advocate of investigating why certain hormone levels are low. There is always a reason for hormonal imbalance and it’s up to you to figure that out with the help of a trained practitioner (like me or a naturopathic doctor).
If your estrogen is low, it’s likely that there is some kind of breakdown along your hormone superhighway. Usually it has to do with lack of ovulation, but it can be attributed to other things as well. Basically, estrogen is not building high enough to cause the spike in Luteinizing hormone that kicks off ovulation. Oftentimes low estrogen comes packaged with other hormone imbalances too – FSH/LH, progesterone, testosterone, thyroid and cortisol to name a few.
We can develop low levels of estrogen in a number of ways:
- Anovulatory cycles – where you don’t ovulate in a cycle. This can be brought on by everything below as well as PCOS, peri-menopause, and premature ovarian failure. Ovulation is the key here – if you’re not ovulating, you need to look at the reasons why, and address that first.
- Hormonal birth control use (especially the birth control pill) which stops ovulation
High levels of stress and cortisol
Over-exercising and disordered eating (not enough food)
Low DHEA – the precursor hormone to estrogen
Additionally, short and light periods are associated with:
- Iron deficiency
- Certain vitamin and mineral deficiencies
- Thyroid problems – this can cause lighter periods
To find out which of these could be causing your short period, I recommend getting the following tests done (these can now be done from the comfort of your own home):
Use code Hormones20 to get 20% off all tests at Lets Get Checked
Female Hormone Test
This at home female hormone test will provide a broad picture of your hormonal health.
Biomarkers covered in the test:
- Follicle Stimulating Hormone (FSH)
- Luteinizing Hormone (LH)
This thyroid antibody test will provide a complete picture of how your thyroid is performing.
- Thyroid Stimulating Hormone (TSH)
- Free Thyroxine (FT4)
- Free Triiodothyronine (FT3)
- Thyroglobulin Antibodies (TGAB)
- Thyroid Peroxidase Antibodies (TPO/TPEX)
This at home Iron test identifies iron deficiencies in your body, with online results in 5 days.
- Total Iron-Binding Capacity (TIBC)
- Transferrin Saturation
How long should your period be?
In my experience, a 3-day period is the norm for many women. Ideally, I like to see a period that is about 4-5 days long. This signifies that you had adequate estrogen building up your uterine lining earlier in your cycle.
Some women have 6-7 day periods and that is fine too, but a period that is 8 days or longer is too long and can set you up for anemia. Also, abnormal uterine bleeding (AUB) can cause anemia too – this is bleeding during your cycle when you know you’re not having your period.
Note: Every woman is different. I am not saying you are abnormal if you have a 2 day period, I am just saying that you may want to first confirm that you are ovulating, and then further explore whether there is an underlying hormonal imbalance.
What can you do if your period is too short?
How can you ramp up your flow from mere spotting or 1-2 days? Here are some of my best tips. As I said above, if your estrogen is low it’s likely that your progesterone is not doing too great either. Luckily some of what I offer below will help both hormones. 🙂
PS. Do 1-2 of these at a time to see if they work, otherwise it can get overwhelming!
1. If you’re on hormonal birth control I recommend getting off it. There is no way to improve low levels of estrogen when your body’s hormone levels are constantly being manipulated by synthetic hormones and you are not ovulating. This is a scary prospect for some people, but I have a solution for that with my Fix Your Birth Control Protocol.
2. Add in more iron-rich foods like red meat, beef and chicken liver, lamb, turkey, tuna, eggs and shellfish. Vegetarian sources are squash and pumpkin seeds, cashews, almonds, lentils and other beans, oatmeal, barley, spinach and other dark leafy greens.
3. Take an iron supplement – I have found Seeking Health Iron Plus Cofactors and Floradix Liquid Iron & Herbs (sometimes this one is too sweet though) to be very effective for myself and for many of my clients. I also like Megafood Blood Builder too. In my experience, taking either of these supplements for about 8-12 weeks lengthens a period by an average of 1-3 days!
4. Increase vitamin C-rich foods or take a supplement – this super-duper antioxidant helps your body absorb iron from plant-based food sources of iron when eaten together. You might also want to try a supplement, especially since many of us have impaired gut function and might not necessarily be absorbing our nutrients as effectively as we should. My favorite vitamin C supplements are: Livon Labs Lyposomal Vitamin C (highly absorbable) or Seeking Health Optimal Vitamin C Powder. Aim for 1000mg a day. Vitamin C raises progesterone too!
5. Add in some phytoestrogens – these are not true estrogens but the idea is that they exert a weaker estrogenic effect on our cells. These are found in many plant foods, the highest source being isoflavones (soy) and lignans (flax). Add in some fermented organic soy into your diet 1-2 times a week or try 1 tablespoon of ground flax seed or flax seed oil a day.
6. You might also want to try Red Clover tea – this is also an isoflavone and an amazing source of vitamins and minerals crucial to liver and kidney function. It helps improve cervical fluid production, and has been used traditionally to treat irregular periods and infertility. Make sure to get an organic tea like this one, and aim for 1-3 cups of tea a day.
6. Try seed cycling – this is a technique that helps to naturally rebalance estrogen and progesterone levels with the use of various seeds during the two phases of your menstrual cycle. It helps with anovulatory cycles and short, light and irregular periods. Check out my blog post and downloadable handout here.
7. Give your gut a helping hand – remember that you can do all this good stuff, but if your gut isn’t absorbing nutrients properly, it will all be in vain! So at the very minimum, make sure you’re including lots of fermented foods like sauerkraut and kim chi and/or taking a great probiotic like Megaspore Probiotics.
8. Check out maca – this South American root gets a LOT of press, and for good reason. It has been used for centuries to balance sex hormones, raise libido and improve energy and vitality. Honestly, the list of things maca does seems endless but most importantly it does a damn good job of improving symptoms of low estrogen!
You want to make sure you get gelatinized maca which has been cooked – it’s more digestible and better utilized by the body in this form. Cooking also reduces the potential goitrogenic effect of maca*. Plus it’s also never eaten raw in Peru which is a good indicator of how we should eat it. I recommend Navitas Naturals Organic Gelatinized Maca or these Organic Veg Caps. It is potent so I recommend starting with 1/2 teaspoon or 2000mg a day to see how it affects you. Remember, not every food or herb is right for everyone so it’s important to pay attention to how you feel when experimenting with something new.
*Goitrogens are compounds that can interfere with thyroid function, especially in people who already have compromised thyroid function.
9. Get weekly acupuncture – honestly this was the catalyst for my hormonal healing! There are numerous studies proving it’s effectiveness at balancing hormones and improving fertility. If you’ve never tried, I HIGHLY recommend it! Or, if you can’t get to an acupuncturist or you don’t like needles, check out Aimee Raupp’s free Fertility Enhancing Acupressure Guide. Aimee is the fertility acupuncturist extraordinaire and this guide includes a worksheet and video discussing location, function and the emotional correlation of each acupressure point and is a great way to regulate your hormones and optimize your fertility from the comfort of your own home.
Alright kids! That sums up some of the best ways to begin addressing the root causes of periods that are too short/light. What do ya think of them? Anything else you’ve done that worked for you? I’d love to know in the comments!
Now we’ll move on to periods that are too heavy/long…
Heavy periods (Menorrhagia)
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.
What does a heavy period look like?
Women often describe their “can’t stop, won’t stop” periods as a major disruptor in all areas of their lives. From work to dating to going to the beach and exercising, a heavy flow can feel really unmanageable. Not to mention potentially MORTIFYING. Women complain to me of constantly worrying about revealing leaks or accidents, ruining underwear and favorite outfits, feeling stressed about simply leaving the house or doing normal activities, as well as the full on exhaustion that comes with excessive blood loss.
Here are some physical signs of a heavy period:
- Your period consistently lasts more than seven days.
- You’re changing regular tampons, pads, or period underwear more than every two hours each day or a full 30 mL menstrual cup more than twice a day.
- You need both a pad and tampon to control your menstrual flow.
- You have to get up and change your pads or tampons during the night.
- You have a menstrual flow with blood clots an inch long or longer.
- You experience tiredness, you lack energy, or you are short of breath, or you’ve been diagnosed with anemia.
I used to have horribly heavy periods when I was younger. I remember years ago I was in Grand Central Station in New York, 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—yup my period had made it past both, and leaked right through my jeans! It was horrific. I ended up missing my train because I spent so much time in the bathroom trying to sort myself out.
And I’ll never forget those days in high school where I literally prayed every month that my period wouldn’t leak through my uniform. I’d wear a tampon, pad, and biker shorts under my dress! It was bananas. I desperately wanted to have a life that wasn’t constantly interrupted by my super heavy flow.
What Is a Heavy Period? Help, I’m drowning in my own period blood!
Normal periods are defined as vaginal bleeding that occurs every 25-35 days, and lasts for three to seven days, with an average blood loss range of 35-50 milliliters or roughly 7-10 teaspoons. Each soaked regular pad or tampon holds roughly 5-12 ml of blood or 1-2 teaspoons, so it’s totally fine to soak 6-10 pads/tampons over the course of each period. You might be thinking this isn’t a lot, but keep in mind most women change their pads and tampons before they’re soaked, so the norm is around 10-20 pads or tampons per cycle.
If your period lasts longer than seven days and you’re losing more than 80 ml of blood per cycle (80 milliliters equals about 16 teaspoons or 2.7 liquid ounces), or you’re soaking more than 16 regular tampons or pads per cycle, then this is a sign that you have a heavier than average flow (menorrhagia). Other signs are flooding (like I described above) and clots that are one inch in diameter or longer. 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. They should serve as a guideline to help you to see where you fall.
How to calculate how much you are bleeding during your period
One fully soaked regular tampon or pad holds approximately 5 mL or 1 teaspoon of blood and a fully soaked super tampon holds 10 mL. A half soaked regular pad or tampon equals 2.5 mL and a half soaked super tampon holds 5 mL.
Make a note in your period tracking app every time you change your pad or tampon, period underwear or menstrual cup (note how full it is) each day of your period to determine if you have a heavy period. If the number of fully soaked regular pads or tampons is more than 16, you’ve fully soaked “regular flow” period underwear more than three times a day, or you’ve changed a half full 30 mL menstrual cup more than six times in any given menstrual cycle, then you have a heavier than normal flow.
What makes a woman have a heavier period than average?
Heavy bleeding can occur at any age, but it is most common at 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. These two times of life are characterized by irregular ovulation, and thus sporadic progesterone production.
Adolescents experience heavier periods likely because of the immature endocrine system, in particular, the immature hypothalamus function. (The hypothalamus talks to the pituitary gland, which talks to the ovaries and tells them when to ovulate, so if the hypothalamus is still developing, there are likely to be hiccups in the system). In addition, estrogen receptors are 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. Without consistent ovulation, there will be a lack of adequate progesterone, which is often a cause for heavier periods.
There are three causes of heavy periods and conditions related to heavy periods.
Hormonal imbalances can lead to heavy periods
- A period that is heavy, dark, clotted, clumpy, or looks like frozen crushed up blueberries, is indicative of higher estrogen levels in relation to progesterone. Estrogen is a proliferative hormone, responsible for stimulating the growth of the uterine lining and breast tissue. Breast tenderness, acne, PMS, headaches or migraines are linked to an estrogen dominant situation.
- 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 hypothyroidism or low thyroid function. Thyroid hormone and progesterone are intricately connected—if your body is not producing adequate thyroid hormone, your progesterone levels may drop, causing estrogen to become dominant over progesterone. In addition, low thyroid function is linked to poor estrogen detoxification. In other words, hypothyroidism inhibits the gut and liver’s ability to effectively remove excess or used up estrogens from the body.
- This thyroid antibody 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 cause heavy or long periods
- Endometriosis (see page xx) and Adenomyosis (see page xx)
- Uterine fibroids:Fortunately, the type of fibroids that cause heavy bleeding (submucus fibroids) only account for 5-10 percent of all fibroids. However, fibroids are generally fed by estrogen excess, which can also cause a thickened uterine lining and heavier bleeding.
- Polyps:these can cause abnormal uterine bleeding, but it is not usually heavy. See Spotting or Irregular Bleeding (page xx).
- Miscarriage, ectopic pregnancy, or the postpartum time can all cause heavy bleeding.
Other illnesses, diseases or medications that could be causing your heavy flow
- Medications such as the depo-provera shot, as well as the Paragard (copper) IUD.
- A bleeding disorder called 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 (heavy periods) have a blood coagulation problem.
- Liver, kidney, and pelvic inflammatory disease.
Note: Endometrial cancer may cause abnormal uterine bleeding in the form of spotting or bleeding in between periods, but it rarely causes heavy bleeding.
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 inactivate estrogen effectively if a woman is deficiency in the B complex of vitamins. This leads to higher estrogen, and heavier periods. Supplementing with the B Complex will help restore the proper metabolism of estrogen. I like Thorne Research Basic B Complex and Seeking Health B Complex.
- Vitamin C – One study found that vitamin C was able to reduce heavy bleeding in 87% of it’s participants. It’s also important in preventing and treating anemia because it helps improve the absorption of iron. I like Livon Labs Lipospheric Vitamin C or Rainbow Light Buffered Vitamin C Powder. 2000-4000mg a day.