Heavy periods - Definition

“Whoa, that’s Niagara Falls !” It's going to overflow, it's going to overflow..." "Damn, there are no more super ultra extra night flow packets anymore ..." "Okay now, it's not possible, it's flowing too much, I'm putting two towels on top of each other. other ! » If any of these phrases resonate with you or make you laugh (yellow), you are probably one of the many menstruators who experience what are called heavy periods each month . Very frequent changes in hygienic protection , continual fear of the famous leak , limitation of social activities: a daily life that is painful and complicated to manage. It is an intimate individual experience that we rarely talk about around us. The points of comparison useful for judging the situation are therefore limited. So, it is very difficult to know whether this abundance of periods is normal or not. But then, what are the criteria to take into account to consider that we have a heavy menstrual flow ? And if so, is it normally abundant or too abundant ?

Heavy periods: blood volume lost as an objective definition criterion

Non-existent, very light, light, moderate, abundant, very abundant, hemorrhagic: it is not easy to place oneself on the scale of the intensity of the menstrual flow. And where should we place the normality cursor? The scientific community agrees that a menstruating person has normal periods when several criteria are verified, in particular when the volume of blood loss during a period of menstruation does not exceed 80 ml ^1-2 .

Normally heavy periods up to 80 ml of blood lost per cycle

A healthy woman of childbearing age loses on average between 35 and 50 ml ¹ during her period. These are generally strongest during the first 2 or 3 days then gradually diminish. This blood volume can usually vary between 5 and 80 ml ² from one cycle to another depending on the person and the context. It depends on the state of health, age or method of contraception. For example, wearing a copper intrauterine device (IUD) is often associated with heavy periods with larger blood clots than when taking an oral contraceptive.

Having heavy periods therefore means losing between 50 and 80 ml during a single period of menstruation. Around 50 ml, the flow is said to be moderately abundant; a flow of around 80 ml is considered very abundant.

Above 80 ml, abnormally heavy periods

Menstruation is considered abnormally heavy when the total blood flow during the menstrual period exceeds 80 ml. In medical language, this is hypermenorrhea ³ : periods have a normal average duration of 4 to 8 days ² but are too heavy compared to this threshold of 80 ml. In English, this phenomenon is described by the expression “ heavy menstrual bleeding ” ⁴ , abbreviated as HMB. Commonly translated in French as “heavy menstrual bleeding”, it actually implies a flow of such abundance that it becomes particularly annoying in everyday life. This disorder is part of the menorrhagia ³ family : these are abnormalities of the menstrual cycle characterized by an increase in the duration or abundance of periods. We also speak of abnormal uterine bleeding ⁵ (SUA ⁶ ) during menstruation. In this case, it is necessary to consult a competent health professional to establish a diagnosis, understand the origin of the problem and consider treatment.

But is this single quantitative data on menstrual blood volume sufficient to define heavy periods in their entire complexity? The difficulty in characterizing menstrual flow also lies in the great variability of individual situations and in the subjectivity of personal feelings.

Subjective criteria to define the abundance of periods

Every woman experiences her menstrual cycle differently. By enduring them every month and testing the various protections available to them, menstruating people themselves evaluate the nature and abundance of their losses. They do so according to subjective criteria, based on their personal experience, which is rarely shared. They have their own appreciation of what is normal and what is not. And it is generally this individual interpretation that triggers a medical consultation in case of doubt. Some women experience abnormally heavy periods without ever considering it problematic or requiring medical attention. Conversely, others feel profound physical and psychological discomfort due to bleeding that they consider too abundant and seek medical advice for this; However, they do not suffer from abnormally heavy periods in the strictly quantitative sense of the term.

This is why the National Institute for Health and Care Excellence (NICE) in the United Kingdom recommends defining HMB as "excessive menstrual blood loss that interferes with with the woman's physical, emotional, social and material quality of life, and which can occur alone or in combination with other symptoms. » ⁴ Beyond the quantitative aspect, this definition integrates the notion of the impact of periods on the quality of life of menstruating people. Giving up going to work, canceling an important medical appointment, hesitating to practice a sporting activity, abstaining from sexual intercourse, refusing to wear a swimsuit, depriving yourself of a friendly outing. So many examples of negative consequences whose occurrence can be measured to assess the more or less abundant nature of menstruation.

 

The abundance of periods is therefore naturally defined by the objective criterion of the quantity of blood lost per cycle. But, to make a complete and fair clinical evaluation of each case, subjective criteria must also be taken into account. These are linked to the perception that each person has of this physiological phenomenon and the repercussions that it has on daily life. And you, are you concerned? Are you looking for solutions for heavy periods ? Do you know about menstrual lingerie ? Perdième designed its abundant flow menstrual shorty . Available from 34 to 46, perfectly covering the buttocks, waist and hips, the Budapest , Pondicherry and Taipei menstrual shorties will offer you optimal protection with absorption equivalent to 5-6 medium tampons.

NB The figures in this article are given for information purposes only, based on sources cited below. However, these are statistics. Any real extreme and unusual manifestation should alert. For any medical advice, it is imperative to consult an authorized health professional – general practitioner, gynecologist, midwife – who is the only one capable of making a diagnosis.

Written by cd

Sources:

1. Warrilow, G., Kirkham, C.C., Ismail, K.M., Wyatt, K.M., Dimmock, P., & O'Brien, S. (2004). Quantification of menstrual blood loss . The obstetrician and gynecologist, 6 .
2. Ian S. Fraser, HOD Critchley, MG Munro, M. Broder. Can we reach international agreement on the terminologies and definitions used to describe menstrual bleeding abnormalities? Human Reproduction, Volume 22, Number 3, March 2007, Pages 635-643.
3. National College of French Gynecologists and Obstetricians (CNGOF). Genital hemorrhages in women . French-speaking Virtual Medical University (UMVF).
4. National Collaborating Center for Women's and Children's Health (UK). Heavy menstrual bleeding. London: RCOG Press; 2007 Jan. (NICE Clinical Guidelines, No. 44.) 3,Impact of HMB on women .
5. Davis E, Sparzak PB. Abnormal uterine bleeding . [Updated September 9, 2022]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; January 2023.
6. Pinkerton, J. V. (2022, March 11). Abnormal uterine bleeding (AUB) . MSD Manuals for the general public.