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    Is Your Period Too Heavy? We've Got Answers

    How much blood is too much blood, really?

    If you have a period on the heavier side, you've probably wondered how much bleeding is *too* much bleeding. So, we asked two gynecologists everything you could possibly want to know about heavy periods and what to do about them.

    Here are answers to your most common questions from board-certified OB-GYNs Dr. Mary Jane Minkin, clinical professor of obstetrics, gynecology, and reproductive science at the Yale School of Medicine and Dr. Cindy Basinski:

    1. What exactly constitutes a "normal" period?

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    Because every body — and every period — is unique, it's difficult to define a normal period in black and white terms, says Minkin. That said, here are some markers of a typical healthy period:

    • Comes pretty regularly ~around~ once a month (which could be anywhere from 21 days to every 35 days)

    • It usually sticks around for about six days or less

    • When it does, you go through no more than a tampon or pad every couple of hours. OR, if you use a menstrual cup, you bleed more than 80 milliliters per period or so (which you can keep an eye on depending on the capacity of your cup)

    2. Then what does it mean to have a heavy period?

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    There are two ways you might be bleeding too much: the literal amount of blood and the number of days you bleed at a time. Medically speaking, the definition of a heavy period is more than 80 milliliters (which is just over a third of a cup) over the course of your period or a period that lasts a full week or longer.

    But since you're probably not in the habit of measuring out your period blood, there are practical signs you can look out for instead. "If you’re flooding and staining a lot of clothing on multiple occasions during your cycle, or if you’re having to put towels under you on furniture or on bedding to catch blood, you’re very likely bleeding more than a third of a cup during your period," says Basinski. "If you’re changing your tampon or pad or emptying a menstrual cup more than every couple of hours on any given day, you’re likely having heavy bleeding."

    3. What about getting big ol' clots?

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    Yup, those also most likely hit the criteria for heavy bleeding — keep an eye out for clots the size of a quarter or bigger, because once you're passing those, you're probably passing more than a third of a cup during your cycle, according to Basinski.

    4. Okay, but how heavy is *too* heavy, really?

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    Honestly, it's super subjective. Minkin has had patients who have come in with pretty normal bleeding convinced they were spurting Niagara Falls, while some other patients who actually *were* at waterfall levels didn't care at all.

    So tbh, it's ~too much~ when it's disrupting your life. "For example, you regularly have to go to the bathroom because you're afraid you're going to stain all the time," says Basinski. "Or you're turning down plans because you're on your period and you feel like you can't leave the house. Or if it's interfering with your sex life and your relationships." There's no scientific bar you have to pass — if it's heavy enough that it's messing with the way you live your life, then it's too heavy.

    5. Um, that sounds like me! Should I be worried?

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    Don't be worried, but definitely see your doctor so you can start doing something about it! Heavy menstrual bleeding is very common; about one third of women seek treatment for it, according to The American College of Obstetricians and Gynecologists. And while heavy bleeding might be a sign of an underlying health problem that needs treatment, there's no need to freak out until you know what's going on.

    6. Sooooo, why do some people have nightmare periods from hell when there are other people out there getting by with lite tampons and panty liners?

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    Honestly, sometimes the cause of a heavy period isn't known — some people just bleed more than others, says Minkin. At the same time, here are some things known to be associated with heavy menstrual bleeding (though not always):

    Structural abnormalities such as fibroids and polyps, which are growths in the uterus. Find out more about the difference between them here.

    Irregular ovulation caused by puberty and perimenopause, or medical conditions such as polycystic ovary syndrome and hypothyroidism. This is because when you don't ovulate regularly, the lining of the uterus can become super thick. So when your period does finally come? "It's a festival of blood," says Minkin.

    Endometriosis. AKA, a condition where the tissue that normally lines the inside of the uterus actually grows outside of the uterus (typically on your ovaries, fallopian tubes, or pelvic organs).

    Pelvic inflammatory disease. AKA, an infection of the female reproductive organs that is often a complication of some STIs, but not always.

    Bleeding disorders that cause blood not to clot properly.

    Certain medications like blood thinners and aspirin.

    Endometrial cancer. But this is rare and usually diagnosed in women who are past menopause — meaning that heavy menstrual bleeding is definitely a sign that something isn't right.

    It sounds like a lot — thanks, body 🙃 — but don't fall down a WebMD rabbit hole. Your doctor will help you figure out what's actually going on.

    7. My doctor told me my period is normal, but TBH it really doesn't feel normal. What should I do?

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    Most doctors really want to help you, so make sure to come to your appointments prepared with as much information about the symptoms you're dealing with as possible, suggests Basinski. The more specific info you can tell them about your menstrual cycle, the better, so it's reeeally helpful if you're in the habit of using a period tracker app or calendar. If not, that's okay too, but definitely be prepared to answer questions about your past couple of cycles, such as how long the cycle lasted, how many days you bled, the intensity of your flow, etc.

    Write notes if you need to so you don't forget anything and try your hardest not to downplay your symptoms — because listen, it's no joke that sexist stereotypes can get in the way of a proper diagnosis.

    And if you're not having a good experience with your doctor — even if it's just a bad personality match — look elsewhere. Doctors want you to feel a positive connection with them just as much as you do. Never be afraid to get a second opinion, either.

    8. Is there anything I can do about heavy bleeding or do I just kind of live like this?

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    There's plenty you can do! Heavy bleeding that disrupts your life is something you should get treatment for, no matter how much you've been taught that shitty periods are things you just have to deal with. Obviously your doctor will be the one to talk to you about the best treatment for you, but just as an FYI, here are some of the options that might come up:

    Hormonal treatment just as birth control pills, hormonal IUDs, and hormonal injections. "These treatments work well for young women because they are reversible most often and allow them to maintain their fertility if they're interested in having children," says Basinski.

    Other drugs that control blood flow. Things like ibuprofen have been show to moderately decrease blood flow, according to Basinski. Then there are drugs such as tranexamic acid (like Lysteda) that you take during your period that can help you clot better.

    Surgery to get rid of fibroids and polyps if you have them.

    Uterine artery embolization, which is used to treat fibroids by blocking blood vessels to the uterus so fibroids are unable to grow. Because a doctor uses a catheter to inject embolic agents into the uterine arteries to cut off blood supply, it is an alternative for those who don't want surgery to treat fibroids, according to Minkin.

    Endometrial ablation, which is a procedure to destroy the lining of the uterus to stop or reduce menstrual bleeding. According to Basinski, there are several different endometrial ablation technologies on the market. Most of them take a few minutes to do and can be done in the doctor's office, though some physicians go to the operating room too. Though it also inhibits fertility, it doesn't have the surgical risks of a hysterectomy. "You’re not taking an entire organ out, you’re just removing the internal service of an organ," says Basinski.

    A hysterectomy, which is the surgical removal of the uterus. According to Basinski, hysterectomies are attractive to patients because of their 100 percent effectiveness rate — no uterus, no periods! — and are typically discussed as an option for more serious cases of abnormal bleeding when other types of treatment have failed or are not an option.

    9. Nice! Is there anything else I should know?

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