Heavy periods are more than just a pain in the a**, but can also be an indication of other more serious medical conditions. But what exactly constitutes abnormal menstrual flow? Most people with heavy periods are around the upper limits of 12 to 16 fully soaked through pads per period, so how would you know if your bleeding is normal or not? Officially, abnormally heavy bleeding (also known as menorrhagia) is defined to be blood loss greater than 80ml per cycle, which is a good 16 fully soaked through pads per period. Additionally, if your period lasts more than 7 days, you may also be experiencing heavy menstrual bleeding. Menorrhagia would usually cause significant disruptions to your daily life, through anaemia or due to the need to constantly change your sanitary pads.

1. Why me?

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No conversation about menstruation would be complete without bringing in the hormones estrogen and progesterone. And this case is not an exception; menorrhagia is a result from hormonal imbalances where there are higher levels of estrogen, and lower levels in progesterone than normal. Estrogen is what triggers the thickening of the uterine lining, while progesterone signals for the maintenance of the uterine lining in preparation for implantation. However, when estrogen levels are higher and progesterone levels are lower, then the uterine lining gets thicker than normal, and is more likely to be shed, leading to heavy periods.

This pattern of hormone production is particularly common in teens who just started menstruating, or ladies who are nearing menopause. Hormone imbalances can also be triggered in women on birth control, a certain medication, or in women with thyroid problems.

2. How do I know if I need medical help?

Normally, hormone imbalances are quite treatable, and hormones can be regulated with medication easily. However, abnormal bleeding can also be a signal for more serious conditions, such as uterine cancer, infections, bleeding disorders or fertility issues. So if excessive bleeding lasts for several cycles, or just greatly affects your quality of life, then go ahead and get checked by a gynaecologist. Additionally, blood clots that are larger than 1-inch in diameter are another warning signal that may point to possible menorrhagia.

3. What can I do?

Well if you notice alarming symptoms and and have already been getting your period for quite some time, then of course get checked by your doctor. But other than that, make sure that you are getting enough iron through supplements to prevent you from becoming anaemic, that may make you feel weak or easily fatigued.

Just because you feel that all-too-familiar “waterfall” feeling down there, don’t go jumping to conclusions about your menstrual flow. Your flow, more often than not, will fall within the normal range, but if you do feel any abnormal symptoms, or if your flow is really significantly heavier, then make sure to get yourself checked!