When Your Period Isn’t Going With The Flow: What’s Normal, What’s Not

Your period can tell you a lot about your health. That’s why it’s important to pay attention to your cycle. In our latest edition of “What’s Up, Down There,” we break down the basics of various menstrual bleeding patterns and understand what’s normal versus what might require a visit to your doctor.

Before diving into specifics, it’s important to remember that your normal might be different than someone else’s. When trying to decode your menstrual cycle, it’s best to establish a personal baseline. Spend some time tracking your cycle length, bleeding duration, and flow intensity for a few months. This will help you notice any ongoing changes.

What’s Considered Normal?

On average, a typical period flow lasts anywhere from 3-8 days, with 5 days being the average. Typically, the first few days you may experience heavier bleeding followed by a reduced flow towards the end of your period. On average, bleeding occurs every 28 days, give or take a few days. Cycle length between 21 to 35 days is considered normal.

In terms of volume, a typical volume is about 2-3 tablespoons of fluid (30-40 milliliters to be exact). It can be hard to visualize exactly what this looks like, but if you only need to change your pad or tampon a few times a day (every 4-8 hours) and aren’t completely soaking through them, you’re likely in the range of what is considered a typical flow.

Heavy menstrual bleeding (or menorrhagia as it’s medically known) is often signaled by the following symptoms:

• Needing to change your tampon or pad every 1-2 hours because it’s soaked
• Experiencing blood clots larger than a quarter
• Bleeding that lasts longer than 7 days
• If you’re experiencing any of these symptoms, you should contact your healthcare provider.

There are certain times in life when you may notice your period comes infrequently or stops altogether. For example, some common causes for skipped or infrequent periods include:

• You’re in your adolescent years and just recently developed your period
• You’re taking certain forms of hormonal birth control
• You are pregnant or breastfeeding
• You are entering or have gone through menopause

However, consistent absence of periods (amenorrhea as it’s medically known) could indicate a hormonal imbalance or other health issue that is worth investigating. We explore those causes further below.

Overall, occasional changes in your period are likely nothing to be concerned about, but if your bleeding deviates significantly from your normal patterns for several cycles and those changes aren’t related to a known condition, you should consider contacting your healthcare provider.

Causes and Treatments for An Abnormal Flow

Heavy Bleeding (menorrhagia) is common and something about 1 in 3 women experience. In certain cases, it could be a sign of an underlying health condition such as fibroids, adenomyosis, or endometriosis. It is often diagnosed through a physical exam, a review of your symptoms/health history, and sometimes lab tests.

Treatment for heavy bleeding will vary depending on your unique symptoms. In some cases, prescription medications like hormonal birth control can help to lighten your flow. In others, surgical procedures like an endometrial ablation may be recommended to thin the lining of the uterus. As always, it’s important to discuss the risks versus benefits of any treatment option with your provider.

Amenorrhea, without obvious cause such as pregnancy or menopause, can occur in about 1 in 4 women. Common causes of amenorrhea include hormonal imbalances, thyroid issues, or other concerns. Extreme weight loss, weight gain, over-exercise and stress could cause you to miss your periods. Other hormonal conditions like an overactive or underactive thyroid or polycystic ovarian syndrome (PCOS) could be linked.

Treatment for amenorrhea is again dependent on the underlying cause. Your provider may recommend a specific diet and exercise plan, stress management techniques, or in some cases medication.

When to Seek Help:

• If your bleeding deviates significantly from your normal pattern for several cycles.
• If you experience heavy bleeding that impacts your daily activities or requires frequent pad/tampon changes.
• If you have consistently absent periods, especially with other concerning symptoms.
• If you experience new or worsening pelvic pain during your period.
• If you have concerns about your period or overall menstrual health.

Your Axia Women’s Health provider is an excellent resource in helping provide you with personalized guidance and understanding your unique menstrual cycle. They can help rule out any underlying conditions and suggest management options to help you navigate your flow with confidence.