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Dear LADYist: Help Me. My Monster Period Is Out For Blood

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Since we launched LADYist, we've gotten a steady flow of reader questions about menstruation. Specifically, heavy periods.

  • What's a normal amount of blood?
  • Can I stop or minimize this madness?
  • How in the name of all that is holy am I supposed to deal with this?

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So, in the spirit of Halloween, let's celebrate by talking about blood. A lot of it.


The average period produces about 10 to 30 milliliters of blood -- about two tablespoons, or enough to fill a shot glass.

But about one in five women, by some estimations, experience heavy periods as a consistent feature of their regular cycle. Those exceed 80 milliliters of blood per cycle -- about the size of an espresso cup (or bleeding that lasts longer than seven days).

A group of medical experts in Sweden got together in the 1960s to figure these calculations out, and it's the standard doctors still use to this day.

If you're exceeding that 80 milliliters mark, or you're bleeding for longer than seven days, it's an actual condition called menorrhagia, and it can be an indication of a more serious underlying condition (we'll talk more about that later on).

But here's the thing: Unless you're using a menstrual cup, or you have access to a facility that can perform a complicated chemical analysis of your used pads (called the alkaline hematin test), it's hard to accurately measure exactly how much your period is producing in a single cycle.

Most women with heavy flows simply have to gauge it by, well, how hard they have to work to stem the tide, so to speak.

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(Not an accurate representation of anyone's period.)

Talking about period volume in terms of milliliters can feel abstract for anyone who has to go through many, many tampon or pad changes over the course of a week.

So consider this: a regular absorbency pad or tampon only holds about 5 ml, or about a teaspoon, of fluid. Super absorbent tampons can deal with as much as 10-18 ml (though it's not recommended to use these very often because they carry the risk of inducing toxic shock syndrome).

But even with higher-capacity disposable collection methods, it's normal to go through as many as a dozen or so over the course of your period.


This is a tough question to answer, since there are so many variables that contribute to the intensity and duration of a menstrual cycle. In women who regularly have heavy periods (that aren't caused by a more serious condition), there's not a lot of conclusive evidence pointing to any specific factor that makes them more susceptible.

One factor could be genetics, and women tend to have periods similar to our mothers and sisters (bonus points if you actually have an Aunt Flo somewhere in your extended family).

"I don't think we really understand or can identify whether there's an individual gene [associated with heavy periods]," said Dr. Eleanor Hawkins, an OB-GYN who practices in Fountain Valley, "but there is definitely some hereditary component."

Your age can also play a role, but heavy periods can happen at just about any point during your reproductive years.

Irregular or heavy bleeding is sometimes triggered by misfirings between your brain and your ovaries and uterus, and this confusion is most likely to happen during two distinct phases when your body is going through normal hormonal changes.

One phase is when you start having a period (a magical stage in puberty called "menarche"), and the other is when your period is starting to wind down before menopause (an equally magical stage called "perimenopause").

In cases where heavy bleeding ends up being a symptom of a bigger problem, doctors tend to group those causes into three categories: anatomical or structural problems, hormonal imbalances or blood issues (for example, if your blood doesn't clot properly).

But overall, you'll need to get checked out by a medical professional to know for sure.


If your period is keeping you from going to work, being comfortable, and basically being a normal person, go see your doctor now. And if it's your first time going to the gynecologist, or if you're LGBT-identified, we've got you covered there.

As a general rule of thumb, you should also check in with your doctor if there are any changes to your flow or cycle. For instance, if your period becomes heavier than usual, you're bleeding between cycles, or bleeding longer, those are all... (wait for it)... red flags. Similarly, if you're experiencing dizziness or fatigue with your period, that could be a sign of anemia.

"When you have enough blood loss, there's a risk that you're losing a lot of iron as well, because you're not replenishing it quickly enough," said Dr. Michelle Reddy, an OB-GYN with the Long Beach Memorial Medical Center. "And in some cases, you can also get heart palpitations and other circulation problems with too much blood loss."

Since we're not trained medical professionals, and because the diagnostic process for abnormal uterine bleeding can be fairly involved, we're not going to list all the possible diagnoses here. Your doctor can walk you through some likely scenarios and talk to you about possible treatment plans, which can include hormonal birth control or other medications. There are also a number of non-invasive, non-surgical treatments, but it's up to you to decide what's right for you.


Assuming your doctor has given you a clean bill of health, if your personal Shark Week is more like Megalodon Week, there are a few ways you can make it a little more tolerable.

- Some women simply combo higher-absorbency pads with tampons.

- If you're willing to switch it up, you can try another "collection method" like menstrual cups designed for heavy flows or underwear designed for your period (you can even get spooky ones for Halloween!).

- Track your period so you know if you need to talk to your doctor.

- Eat well and stay hydrated. Iron supplements can help too, Dr. Hawkins said. "You can have a diet rich in iron -- red meat, leafy vegetables, that sort of thing -- but our bodies are really bad at absorbing iron from those sources," she said. "So adding a supplement is a good idea, too." (Keep in mind that it can take months to raise your iron level, but being consistent with it can raise your baseline over time.)

- Also talk to your doctor about non-steroidal anti-inflammatories (FYI: the doctors I spoke with said that they treat painful periods as a separate issue). If you want to go over-the-counter, hit the ibuprofen. When taken at the first sign of your period, it can actually decrease the amount of blood you lose.

Bonus: you do have our permission to dress up like this for Halloween.

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