The average menstrual cycle length from the first day of bleeding to the next start of bleeding is 26 to 34 days. About 20% of menstruating women have an irregular cycle shorter or longer than that range. Your period may last 3-6 days in duration for most women. The amount of bleeding during a period may be anywhere between 30 to 80 milliliters of blood or 2-5 tablespoons. Many factors may affect the length of a menstrual cycle, including stress, diet, other medical diagnoses, intrauterine devices (IUDs), medications, or exercise. Even those women who have a very predictable cycle may experience cycle irregularity within their lifetime. If you have missed a period, consult your physician.
Measuring your menstrual blood loss can be helpful and is typically done by adding up your fully saturated tampons, pads, or underwear during your period. If using a menstrual cup, measuring your bleeding is easier as the cups are usually measured for 30 to 60 mL, depending on the size. Regular tampons and pads hold about 5 mL of blood if soaked and about 10 mL if using a super pad or tampon. A menstrual disc may hold up to 35 mL.
According to the CDC, your menstrual bleeding may be considered excessively heavy if you:
• Are changing your pads and tampons approximately every hour
• Bleeding longer than seven days
• Or have large clots the size of a quarter or larger
Heavy menstrual bleeding can contribute to iron deficiency anemia, which needs to be evaluated by your primary care physician or gynecologist. The cause of your bleeding will need to be determined so that your physician can prescribe proper management and treatment.
Most women experience cyclical emotional or physical symptoms one to two days before their periods. Symptoms like breast tenderness, bloating, food cravings, changes in appetite, bowel movements, or energy are typical and mild. Excessive irritability, anger, anxiety/panic, or depression around a menstrual cycle may be due to a cause outside of a regular cycle. These symptoms should be tracked and discussed with your physician, especially if these symptoms have interfered with aspects of your social, home, school, or work life.
Tracking your menstrual cycle can give you and your health care provider insight into your reproductive health. Several free period tracking apps are available and may assist with fertility planning for those trying to conceive.
"Normal cycles" can differ from woman to woman. The bleeding amount and color of menstrual bleeding can also vary. Speaking with your physician and staying up to date on your wellness visits will be the best way to monitor your health and catch abnormalities.
Resources:
1. https://www.cdc.gov/ncbddd/blooddisorders/women/menorrhagia.html
2. Botanical Medicine for Women’s Health by Aviva Romm
3. UpToDate
4. https://www.ncbi.nlm.nih.gov/books/NBK279294/
5. Moglia, Michelle L. WHNP, MS; Nguyen, Henry V. FNP, MS; Chyjek, Kathy MD; Chen, Katherine T. MD, MPH; Castaño, Paula M. MD, MPH Evaluation of Smartphone Menstrual Cycle Tracking Applications Using an Adapted APPLICATIONS Scoring System, Obstetrics & Gynecology: June 2016 - Volume 127 - Issue 6 - p 1153-1160
doi: 10.1097/AOG.0000000000001444
