Without stating the obvious, a period is the most visible, outward sign of a functioning menstrual cycle (like, duh). But along with a bleed, there’s also all the important hormonal peaks and dips that happen during your cycle, affecting how your periods look and feel from month to month – from the colour of your bleed to the pain level of your cramps. Keeping an eye on your bleeding can be a real insight into what’s going on with your hormones and your body.
Today, Dr Lara Briden, women's health expert and author of Period Repair Manual, shares some key facts about period flow.
Period flow fluid
“Menstrual fluid is not all blood, but also cervical mucus, vaginal secretions and bits of the uterine lining (endometrial tissue). Interestingly, two thirds of your endometrial is not shed but reabsorbed by your body.
Your menstrual fluid should be mostly liquid, with no large clots. As your uterine lining breaks away and sheds, your body releases natural anticoagluants to thin it and help it flow more easily. If you flow heavily, then you may form a few clots because the anticoagluants don’t have time to do their job. Menstrual clots are normal, but they should be few and no larger than 1-2cms. If larger than this, see your doctor.”
Period flow colour
“Blood turns darker when it’s exposed to air so your period will be a bright red colour when you’re flowing quickly and a bit darker when you’re flowing slowly or just spotting. Your menstrual fluid will look almost brown when it has been on your sanitary pad for a while.” Find out more about what the colour of your period blood means.
Period flow volume
“You should lose a total of 50ml (or about three tablespoons) of menstrual fluid over the days of your period. Less than 25 ml is a scanty flow. More than 80ml is a heavy flow. Of course, you’ve probably never measured the actual volume of your flow. You can estimate it by counting the number of menstrual products. One soaked regular pad or tampon holds 5ml, or about one teaspoon. A super tampon holds 10ml. So, 50ml equates to ten fully soaked regular tampons or five fully soaked super tampons spread over the days of your period. In simple terms, you shouldn’t need to change your pad or tampon more than once every two hours during the day. Your flow should slow during your sleep so you shouldn’t need to be up in the night changing a pad.”
If it’s light…
“A light or scanty period does not necessarily mean that something is wrong. You can lose as little as 25ml of menstrual fluid and that is still normal. 25ml equates to five fully soaked regular tampons, spread over all the days of your period. If you see less than 25ml of menstrual fluid then ask yourself: Is it a true period or is it an anovulatory cycle? (When you don’t ovulate in your cycle – you make oestrogen but no progesterone). A true period is one that follows a follicular phase, ovulation and luteal phase”
“If you are confident that you do ovulate, then your periods are going well, despite your scanty flow. You have enough oestrogen or you would not be able to reach ovulation. You just don’t have as much estradiol as most women, which can be the result of things that lower oestrogen such as smoking, under-eating, or too much soy and other phytoestrogens in your diet. If you find no evidence of ovulation or luteal phase, then you are not ovulating and that’s the significant thing about you period. The solution is not to boost oestrogen but to restore regular ovulation. That probably means reducing stress or eating more or correcting a condition such as polycystic ovarian syndrome.”
If it’s heavy…
“A heavy period is blood loss greater than 80ml or lasting for more than seven days. 80ml equates to 16 fully soaked regular tampons or eight fully soaked super tampons, spread over the days of your period. Heavy menstrual bleeding and large menstrual clots can be caused by many things, including the copper IUD, anovulatory cycles, endometriosis, perimenopause, thyroid disease, and coagulation disorders. The most common cause of heavy periods is a hormone imbalance, which is a combination of 1) low progesterone and 2) oestrogen excess.”