Too heavy or not enough… How would you describe your menstrual flow?
Menstruation is a natural and essential part of the reproductive cycle for people who menstruate. However, the volume of menstrual flow can vary a lot from person to person and even from cycle to cycle. This is why it is important to always keep an eye on irregularities in your cycle.
Factors such as hormones, endometrial composition and health status play a role in determining whether a person has light, medium or heavy menstrual flow. Let’s demystify it all together!
So-called “normal” menstrual flow
The average menstrual flow is 30 to 40 ml per menstrual period, or 2 to 3 tablespoons. However, it is not uncommon for some people to lose up to 60 to 80 ml of blood during their period.
It is possible to estimate the amount of your flow each period by calculating either the amount of disposable products used (for example, an "average" flow is equivalent to using a new product approximately every 3 hours) or by calculating the level of blood in your menstrual cup or disc. Note that tilting your pelvis forward can help you remove your menstrual disc while retaining as much fluid as possible inside it.
If your menstrual flow interferes with your daily life or exceeds these indications, we invite you to consult a health professional.
What is your menstrual flow made of?
You might be surprised to learn that "menstrual flow" isn't just blood. It also contains internal tissues, mucus and uterine lining. According to research, your period is 36% blood and 64% internal tissue, mucus and/or blood clots. So, it’s completely normal that your menstrual flow isn’t smooth like “regular” blood.
Some studies classify a flow as "heavy" at more than 80 ml, with possible fluctuations from month to month. However, it is always best to consult your doctor if your menstrual flow exceeds this amount.
“Light” menstrual flow
Light menstrual flow, characterized by blood loss of less than 30 ml and/or the use of lightly absorbed menstrual products, can be influenced by several factors:
- Hormone levels: Hormones, particularly estrogen and progesterone, govern the menstrual cycle. Light flow can occur when these hormone levels are low, leading to a thinner uterine lining and therefore, less blood flowing out.
- Hormonal contraception: Some forms of hormonal contraception work by stabilizing hormone levels, leading to lighter flows by suppressing natural hormonal fluctuations.
- Stress and lifestyle factors: High levels of stress, excessive exercise, extreme weight loss or certain diets can disrupt hormonal balance, contributing to lighter menstrual flows.
- Medical Conditions: Conditions such as polycystic ovarian syndrome (PCOS) or thyroid disorders can lead to irregular and lighter menstrual flow due to hormonal imbalances.
The “average” menstrual flow
A moderate menstrual flow, characterized by blood loss between 30 and 40 ml and/or the use of menstrual products with medium absorption, reflects greater harmony between hormonal and anatomical factors:
- Balanced Hormones and Average Endometrial Thickness: Average flow often results from a stable balance of estrogen and progesterone, ensuring a healthy uterine lining and an appropriate amount of tissue to shed.
- General health: Maintaining good overall health through a good diet, moderate physical activity and reducing stress can help balance menstrual flow and prevent menstrual problems.
“Heavy” menstrual flow
Heavy menstrual flow, marked by blood loss greater than 40 ml and/or the use of high absorption menstrual products, can mean a combination of hormonal, anatomical and health-related factors:
- Higher hormone levels: High levels of estrogen and progesterone can lead to a thicker endometrial lining, requiring more tissue to be shed and leading to heavier menstrual flow.
- Larger uterine cavity: People with larger uterine cavities may have heavier flows due to the increased amount of tissue available for evacuation.
- Hormonal Imbalances: Conditions such as fibroids, endometriosis , and adenomyosis (the presence of endometrial and stromal glands in the uterine musculature) can lead to hormonal imbalances that contribute to heavier menstrual flow.
- Blood clotting factors: Disorders that affect blood clotting can lead to heavier or prolonged bleeding during menstruation.
- Inflammatory Conditions: Chronic inflammation of the uterus and/or pelvic area may contribute to heavier menstrual flow.
- Contraception: The copper IUD and some birth control pills can cause heavier flows.
A little word on nutrition*
If you lose a lot of blood each menstrual period, it would be wise to include more foods rich in iron in your diet and to discuss it with your doctor in order to monitor your iron levels. Low blood iron levels can cause excessive fatigue, headaches and dizziness, anxiety and depression, and cold hands and feet due to poor circulation.
*This advice does not replace that of a nutritionist.
In light of this information, you now know that menstrual flow is influenced by a complex interplay of factors, from hormonal fluctuations and uterine characteristics to lifestyle choices and potential health problems.
A reminder: if you suffer from heavy menstrual bleeding, do not hesitate to contact your healthcare professional.
Understanding the reasons for light, medium, or heavy menstrual flow can give you insight into your reproductive and overall health and help you take action to improve your overall well-being.