What is a heavy period?

Heavy periods can be anywhere on a spectrum from inconvenient to a significant interruption in your work and family life. Heavy periods are often accompanied by pain, like curled up on the bathroom floor kind of pain. Not to mention the worry around leaking or ruining your favorite pants. Some women find it hard to leave the house because they just don’t want to risk an emergency, or the embarrassment and need to get home fast to take care of things. If this is you, I see you!

First, let’s talk about the official term for heavy periods: menorrhagia. Fancy, huh?

Menorrhagia is heavy bleeding. It can also include flooding, and/or passing big clots (bigger than a quarter size). At least 50% of women struggle with heavy periods, and 1 in 6 women experience significant interruption to their quality of life when their period comes around each month. So, heavy periods are something to take seriously, and there are things you can do to ease them up and get to the bottom of why they’re happening. I’ll show you.

How much blood is too much?

The average amount of period blood loss is 30-80 milliliters, approximately 1-6 tablespoons. A regular soaked pad or tampon holds 5 mL of blood, so it’s normal to soak 6-10 pads or tampons during your 4-7 day period.

If you are losing more than 80 mL (6 tbsp+) or using more than 16 pads or tampons during your 4-7 day bleed, then you have a heavy period.

As you track your cycle, it is important to track how much you bleed, especially if you suspect you have heavy periods. Make a note everyday of your period about your flow, here’s a guide to help you track how much you are bleeding based on the menstrual products you use.

A healthy amount of blood/fluid loss during one period is between 30-80 mL, approximately 1-6 tablespoons.

Less than 25 mL (1 ½ tbsp) is light flow

More than 80 mL (5-6 tbsp) is heavy flow

Optimal flow is around 50 mL (3-4 tbsp) of blood/fluid loss during one period.

One soaked pad/tampon = 5 mL (1 tsp)

One soaked super tampon = 10 mL (2 tsp)

Half-soaked regular pad/tampon = 2.5 mL (½ tsp)

Half-soaked super tampon = 5 mL (1 tsp)

Healthy flow is around 50 mL = 10 regular soaked pads/tampons (or 5 soaked super tampons).

Adjust your calculation for half-soaked regular pad/tampon = 2.5 mL (½ tsp).

Many women describe heavy periods as significant interruption to their lives when they have to change plans, worry about embarrassing accidents or leaks, interrupt their plans to the beach, ruin their favorite clothes, stress about leaving the house and doing regular activities around work and family life, and the fatigue that comes with excess blood loss.

How do you know if you have heavy periods?

Here are some common signs to know if you have heavy periods:

Your period lasts longer than 7 days
You soak through more than two pads or tampons per day OR use more than six pads or tampons a day
You have to change your pad or tampon after 1-2 hours
You regularly soak through your clothes or double up on pads/tampons
You have to change your pad or tampon during the night
You pass clots bigger than the size of a quarter with your period flow
You have to plan your activities around your period
You feel weak, tired and/or low energy during the day, or you’ve been diagnosed with anemia

What causes heavy bleeding?

Hormone Imbalance

The basic hormone imbalance that causes heavy bleeding is high estrogen levels in relation to progesterone. Estrogen is amazing, it plays an essential role in our reproductive, brain, bone, breast, and heart health. It is a proliferative hormone, which means it makes things grow.

Progesterone is the balancing hormone to estrogen, if estrogen grows the grass, progesterone mows it so it doesn’t get out of hand. But if either estrogen or progesterone is significantly higher or lower in relation to the other, you have a hormonal imbalance and symptoms will show up. Most commonly estrogen levels end up high causing the imbalance with progesterone, so it is important to clear out the extra estrogen which will bring them back into balance with each other.

Estrogen is the primary hormone responsible for growing the uterine lining during the first half of our cycle. Progesterone keeps the lining intact until it is time to shed it during menstruation if no fertilized egg has implanted. During your period, if your flow is heavy, dark purple, has the consistency of crushed-up blueberries, or clots larger than a quarter, that is a sign of high estrogen. Estrogen has built up a rather thick lining and therefore has extra lining to shed, and you end up with a heavy flow with or without clots.

What causes high estrogen levels?

Endocrine Disruptors:

Endocrine disruptors are chemicals in our environment that disrupt our hormones and endocrine system function. They are found in our food, water, cosmetics, body care products, household cleaners, and homes. Xenoestrogens or (foreign estrogens) mimic your natural estrogen and disrupt how it normally functions and increase the level of estrogen circulating in your body.

Medications:

The Birth Control Pill and other estrogen containing hormonal contraceptive medication as well as hormone replacement therapy contain synthetic estrogen that can cause heavy bleeding, even when it is a withdrawal bleed. The copper IUD can also cause heavy bleeding.

Not Pooping Everyday:

It’s true. We produce estrogen, we use it, then we eliminate the excess (through our poop). If the estrogen has not been properly metabolized and cleared from the body, it can recirculate and increase estrogen levels and cause symptoms like menstrual migraines, breast tenderness, acne, and other PMS symptoms.

Imbalanced Gut Microbiome:

There is a group of bacteria in your gut called the estrobolome, it’s primary function is to metabolize estrogen to balance estrogen levels. A disrupted estrobolome can cause heavy periods and other symptoms.

Not Ovulating:

Heavy periods may occur anytime, but they often appear during the teenage years and on the opposite side of the menstrual life cycle at perimenopause. During these times it is common for ovulation to be spotty which creates a high estrogen environment (in relation to progesterone) which can cause heavy bleeding.

The majority of the progesterone we produce comes from our corpus luteum, the gland that forms from the empty space after the egg is released at ovulation. Without an egg release (ovulation), the corpus luteum does not form, which means no progesterone production. We produce progesterone in other parts of our body, but the corpus luteum is the primary source of progesterone production following ovulation.

Teenagers experience heavy bleeding because of their immature endocrine system. When they first get their period, they often don’t ovulate regularly for the first few years which puts them in a high estrogen state (in relation to progesterone) which can cause heavy periods. Also, teens are highly sensitive to estrogen and that will calm down as they mature.

During perimenopause, the ovaries begin to slow down, which means ovulation becomes spotty and creates high estrogen levels (in relation to progesterone). This combination of factors can cause heavy bleeding.

Yes, those teenage symptoms can return as you move through perimenopause, BUT hopefully, at this stage, you will have more wisdom and practice taking care of your body so it can be a more graceful experience.

Low Thyroid Hormone/Thyroid Dysfunction:

Another hormone imbalance that causes high estrogen levels is low thyroid hormone. Low thyroid hormone increases the hormone prolactin (the milk production hormone) and impacts how the ovarian follicles grow, reducing the chances of ovulation and ovulation can get spotty. This dysregulation of the thyroid hormone can show up as longer, heavier periods due to anovulatory cycles.

Additionally, heavy bleeding can also be caused by the following conditions:

Endometriosis: Endometriosis is characterized by endometrial-like tissue growing outside the uterus on other organs or areas in the pelvis or thoracic cavity. The tissue is susceptible to estrogen as well and grows and sheds like the endometrial lining. More tissue shedding causes more heavy and painful periods.
Adenomyosis: Adenomyosis is when the endometrial lining grows into the muscular wall of the uterus and may cause heavy bleeding.
PCOS: One of the hallmarks of PCOS is irregular ovulation, leading to estrogen excess and heavy periods.
Uterine fibroids or polyps: Uterine fibroids are benign tumors in the uterus and can cause heavy and prolonged bleeding. Uterine fibroids are “fed by” estrogen, so excess estrogen can worsen the symptoms with fibroids, including heavy bleeding.
Low uterine tone
Bleeding disorder: an inherited bleeding disorder called von Willebrand disease can show up in women’s early twenties in the form of very heavy periods.
Cervical or endometrial cancers: certain types of cancers present with heavy bleeding and should be ruled out by your medical doctor.
Pelvic inflammatory disease: pelvic inflammatory disease is an inflection in one or more of the reproductive organs including the uterus, fallopian tubes, and ovaries. Symptoms include heavy bleeding and pelvic pain.
Miscarriage: A one-time heavy period could be a sign of a miscarriage if you suspect that you could be pregnant.

Solutions for Heavy Periods: What You Can Do About It

With heavy periods, it is important to seek medical care to rule out any underlying conditions. Additionally, testing for anemia can be helpful too based on how long you have had heavy bleeding.

With conditions, medications, and diseases ruled out, there are some natural actions you can do to balance your hormones, reduce your bleeding, and have a better period experience. Here are some ideas to naturally balance your hormones

Rest While You Bleed

Part of tracking your cycle is practicing cycle awareness. The practice of Cycle Awareness is tuning in to and noting the daily sensations you feel in your body and planning your food, movement, and activities accordingly. Your hormones never stop growing or shrinking throughout your menstrual month, so you are literally a different person each day of your cycle (biologically speaking).

You have four distinct phases of your menstrual cycle that can be likened to the four seasons: winter, spring, summer, and fall. Winter is the season when most living things rest. Your period, or the time when you bleed, is your inner winter, the time when your body needs to rest, especially if you have a heavy flow.

But how do I rest when I’ve got work, kids, and community commitments?

It’s tricky. Our culture and society are not set up to take a weeklong hiatus each month when we bleed (longer if you have heavy bleeding that lasts more than seven days), BUT you can make gentle movements to experience more rest during your day while you are fulfilling your commitments.

For example, schedule days off for the first few days of your period or work remotely instead of going into the office to have more space to yourself and not have to worry about bleeding through your pants and wearing heels. Schedule playdates for your kids so you can have a break. Ask your partner to make dinner, prep freezer meals ahead of time, or order out on period days.

Our culture encourages plugging up the blood, pretending it isn’t happening and moving on. But this can perpetuate your heavy bleeding and be damaging to your psyche that needs to acknowledge what is happening with quiet time to process and release.

It takes more courage and effort to carve out space for yourself to rest while you bleed, but it will actually make your periods better. Rest while you bleed!

Poop Everyday!

The main hormone imbalance associated with heavy periods is estrogen excess, so clearing out extra estrogen daily can improve your flow quickly, even within one cycle. Having a daily bowel movement can assist you with regularly clearing out your excess estrogen to balance your hormones. Drinking more water, eating 6-8 servings of veggies a day, exercising, and sweating are other ways to support a daily bowel movement.

Supplement With the Right Nutrients

Supplements can be a great way to boost your nutrient stores, but they don’t replace a healthy, balanced diet. Food is first, and supplements are second. One nutrient that can be helpful for heavy periods is magnesium.

Magnesium helps regulate blood pressure and blood sugar, improve sleep, decrease stress and improve anxiety and depression, calms the nervous system, and maintains healthy bones. It does A LOT! Supplementing with magnesium can calm your body and help balance your hormones thus improving your heavy bleeding. Taking an epsom salt bath twice a week is a good start to boost your magnesium.

Reduce Exposure to Endocrine Disruptors

Swap your period products. Conventional menstrual pads and tampons have harmful chemicals in them like pesticides sprayed on the cotton. These chemicals can easily get into your body and cause harm. Consider switching to 100% organic cotton pads and tampons, reusable pads, or a menstrual cup.
Swap your body products. The products you use on your skin are easily absorbable and can directly impact your hormones. Consider switching to green products. I recommend starting with lotion, soap and shampoo.
Swap out the plastic. Choose stainless steel or glass for storing your leftover food and for water bottles.

Build Stress Resilience

Our nervous systems cannot sustain constantly being on high alert to run from sabertooth tigers or fighting the enemy all day. In our modern culture, the equivalent can look like dealing with a difficult boss, financial, medical or personal stress every day. Our nervous system is designed to fight, flight, or freeze, handle the threat, then return to our “rest and digest” calm baseline.

But often, we don’t complete the stress response and come back to our calm baseline. Instead, we stay in the fight, flight, or freeze response and get stuck there. It’s our way to survive our difficult boss or pressure to perform or handle our sick loved one. But we must come back to baseline and we can support our bodies to do so by using tools to complete the stress response and build stress resilience into our nervous system. Building stress resilience trains our bodies to respond appropriately to the stressor, then return to calm regulation.

When you notice you are stressed, give one or more of these a go…

Physical activity
Breathing: deep belly breathing
Positive social interaction
Laughter
Affection
Cry/emotional release
Creative expression
Imagining your way through the stressor/situation

Heavy bleeding is more than just painful and inconvenient symptoms, and it can significantly interrupt daily activities and make it difficult to keep up with work and family life. I’ve listed holistic solutions above, and if you want more support with solving your heavy bleeding and feeling better, please reach out for a FREE consultation to see how I can help you. Click here.