Sometimes it can be hard to know for sure whether what you are experiencing is considered normal, especially if you have always had a longer or heavier period than other people you know. So how do you define heavy periods? What does that look like? How do you know for sure?
There are two ways a heavy period is defined. First, if it lasts for longer than 7 days or you lose more than 80mL of blood during it. Second, if you aren’t using a menstrual cup that can be a little hard to determine, but it is also the equivalent of:
- 16 fully soaked tampons
- 8 fully soaked super tampons
This soaking is spread over all the days of your period. To consider the tampon fully soaked, it needs to be full to the point of leaking. If you often use pads with tampons because of this you may have a heavy period.
A heavy period is not changing a partially soaked tampon for hygiene purposes, something that can make determining the true number of tampons you soak harder.
What Else Do You See?
Other indicators of heavy periods include:
- Prolonged bleeding: a bleed of more than 7 days. May have underlying causes and generally needs further medical investigation.
- Menstrual clots: your natural anticoagulants may not be able to keep up during a heavy period, leading to you passing clots. Some tiny clots are fine, but several larger than a 10-cent coin need further investigation
Causes of Heavy Periods
There are a few different things that can contribute to heavy periods, but the most common cause is hormonal imbalance. There are two different factors that come into play here:
- Low progesterone
- Oestrogen excess
Oestrogen excess occurs when there are higher than normal levels of oestrogen in your body. This can be caused by:
- Higher ovarian production of oestrogen, which usually only happens when you are in perimenopause.
- Impaired metabolism or detoxification, also known as the removal of oestrogen from your body. It is a two-step process. First, the liver inactivates oestrogen by conjugating it, where it adds a little ‘handle’ to the oestrogen. Then it is eliminated through your gut via the action of your microbiome.
Liver conjugation can be impacted by drinking alcohol, even only one glass a day.
Your liver also needs a good supple of B vitamins, zinc, magnesium, selenium and protein to make sure it conjugates all the oestrogen that passes through it.