If your menstrual cycle education was anything like mine, you were given precious little information about what a normal period is supposed to look like, and since your only experience of menstruation is your own, it’s easy to assume that your period is normal and everyone else’s period must be kind of like yours. If so, you’re not alone. This phenomenon actually shows up in the research since women who have heavy periods often report that their periods are light, and women with light periods often report that their periods are heavy.
Ultimately, your opinion of what a heavy or light period looks like is highly subjective, and very much based on your personal experience.
So what’s normal anyways? And where do you fall on that spectrum?
A normal period lasts about 3-6 days, has a bleeding pattern that starts out moderate or heavy, gradually tapers off, and follows a crescendo/decrescendo type bleeding pattern.
You can expect that 90% of your total blood loss will take place within the first 3 days of your period with your second day of bleeding being the heaviest.
What colour should it be?
You can expect your period to be a variant of red. Bright red, deep wine, burgundy, or look something like beet juice. On your light and very light days you can expect to see light pink or brownish coloured bleeding.
Now for the big question…
How much should I be bleeding?
The amount of bleeding you have will vary and definitely isn’t the same from woman to woman, but even with individual differences taken into account a normal range of bleeding has been identified.
Although the specific range of “normal” will vary a bit depending on which study you’re looking at, a normal period ranges from about 25 to 80mL of bleeding. This is the total amount if you were to measure all of your bleeding from the first to the last day of your period.
The average amount of bleeding between women ranges from about 35 to 50mL over the course of their menstrual cycle (2 – 3 menstrual cups full), and the upper limit of 80mL is used to define what’s normal because women who regularly lose more than 80mL of blood during their periods tend to have an increased likelihood of developing an iron deficiency.
To put that into perspective 25mL is just under an ounce, and if you use a menstrual cup, you would be able to fill your cup at least once with the total amount of bleeding you had on all the days of your period combined. 80mL means that you’ve filled at least 3 1/2 to 4 menstrual cups over the course of your period.
If you use pads or tampons you can do the math considering that depending on their level of absorbency, you can expect each pad or tampon to hold anywhere from 1mL (very light) to 10mL (super/very heavy) of bleeding.
In my client work I have found that there is a wide variety of bleeding between women. Some women experience much heavier bleeding than the upper normal limit of 80mL and others experience much lighter than the lower limit of 25mL.
An important caveat to mention is that there is no such thing as a “perfect period” or some magical amount of bleeding you’re supposed to have. What’s more important is how healthy your menstrual cycle is overall, and how your period fits into the broader context of your menstrual cycle health.
Why do I bleed so much?
If you find that you regularly have more than 80mL of bleeding during your period, don’t panic. Your period is not necessarily abnormal, but there are a few things you’ll want to consider: Have you been checked for fibroids? Adenomyosis? Endometriosis? Uterine polyps?
There are a number of conditions that are associated with heavy bleeding, and if you find that your period is akin to a great flood of biblical proportions, to the point that you need to change your pad or tampon every hour on the first 2 days of your period (or you have to change your menstrual cup every 2 hours), then it’s worth asking your doctor to do an ultrasound (abdominal and trans vaginal) so you can get a complete view of your reproductive organs (uterus, ovaries, fallopian tubes, cervix, vagina).
Endometriosis is not something that is easy to diagnose unless you have a laparoscopy, but either way, having an ultrasound done is a good starting point on the path to figuring out if your periods are normal.
You’ll also want to have your iron levels checked. Iron is an interesting chicken or egg situation when it comes to heavy bleeding. It makes perfect sense that if your period is extremely heavy you could go on to develop an iron deficiency because you’re loosing so much blood every month, but on the flip side, an iron deficiency can actually cause you to bleed more in the first place.
If you find that your iron is low and you go on to correct that deficiency, you’ll likely see a reduction in the amount of your bleeding.
What if my period is way lighter than normal?
If your period is consistently less than 25mL, you’ll want to take a closer look at your other menstrual cycle parameters to get an overall picture of whether or not your cycle is healthy.
You only have true menstrual bleeding after you ovulate. Your period is a reflection of how effectively your uterine lining has developed over the course of your menstrual cycle in response to your estrogen and progesterone levels.
There are two important stages in the development of your uterine lining: 1) the proliferation of your uterine lining as you approach ovulation, and 2) the maturation of your uterine lining in your postovulatory phase. In order for your uterine lining to develop, grow, and completely mature you need to be pumping out healthy amounts of estrogen and progesterone over the course of your cycle.
If you’re not making enough hormones, (for instance if your progesterone levels are too low), then your lining won’t fully develop and mature to the point that it can support the life of a fertilized egg. If your lining is too thin you won’t be able to get pregnant because the fertilized egg won’t have anywhere to implant.
What does this have to do with my period?
If the total amount of bleeding you have during your period is extremely light, it is a reflection of your hormone levels, and to what extent your endometrial lining has (or hasn’t) fully matured.
An interesting study that examined the relationship between pregnancy and endometrial thickness found that there was a minimum endometrial thickness that was required for pregnancy. The study showed that participants whose endometrial lining was thinner than 7mm did not conceive.
It turns out that too little bleeding can be as big of an issue as too much!
Now I want to hear from you! Where do you fall on the continuum? Do you have heavy periods? Are they light? Are they somewhere in the middle? Did your periods change when you came off the pill? Share your thoughts in the comments below!