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By William H. Parker, MD

Clinical Professor of Obstetrics and Gynecology
UCLA School of Medicine
Santa Monica, CA

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Q: I have very heavy periods. How can I tell if this is normal or not?

Blood loss during a normal menstrual period is about 5 tablespoons, but if you have a condition called heavy monthly bleeding, you may bleed as much as 10 to 25 times that amount each month. You may have to change a tampon or pad every hour, for example, instead of three or four times a day, or you may use double protection with a tampon and a pad. You may need to wake up at night to change protection. Heavy menstrual bleeding generally interferes with your normal daily activities.

Millions of women bleed so heavily during their periods that they have to put their normal activities on hold. Below is a list of signs and symptoms of heavy menstrual bleeding. If you answer yes to any of these questions, talk to your health care provider about your period and possible treatment options.

  • Does your bleeding soak through one or more pads or tampons every hour for several hours?
  • Do you need to change your sanitary protection during the night?
  • Do you often double up sanitary protection to manage your heavy flow?
  • Does your period make you miss school or work?
  • Do you have to organize social, leisure and physical activities around your period?
  • Does your heavy period limit your daily activities? If yes, how many days on average each month?