Factors such as hormones, uterine characteristics, and health conditions play a pivotal role in determining whether an individual experiences a light, medium, or heavy menstrual flow.
“Normal” Menstrual Flow
The determined average for menstrual flow is 30 to 40 milliliters per menstrual period, or 2 to 3 tablespoons. However, it is not uncommon for some individuals to lose up to 60 to 80 milliliters of blood.
Menstrual flow can be monitored using the flow lines on your DIVA Cup, and any irregularities noted. If flow volume interferes with your day-to-day life, or exceeds these guidelines, check in with your health care provider.
Important Note: What’s Inside Menstrual Flow?It’s important to note that “menstrual flow” isn’t only blood. It also contains tissue, mucus, and uterine lining. According to one study, your period is 36% blood and 64% tissue, mucus, and/or blood clots.
If you’re curious about how much actual blood you’re losing each month, keep record of the milliliters you are disposing of each time you empty your menstrual cup. Multiply that number by 0.36 to determine blood quantity and add up these numbers at the end of your period.
Some studies cap “heavy” flow at closer to 80 mL, and month-to-month fluctuations do occur. However, it’s always best to check in with your healthcare provider if you fall outside this range.
Light Flow: The Delicate BalanceA light menstrual flow, characterized by minimal blood loss and the use of panty liners, very light tampons/pads, or a DIVA Cup Model 0 can be influenced by several factors:
Hormone Levels: Hormones, particularly estrogen and progesterone, govern the menstrual cycle. A light flow might occur when these hormone levels are low, resulting in a thinner lining of the uterus that requires less shedding.
Hormonal Birth Control: Some forms of hormonal birth control work by stabilizing hormone levels, leading to lighter flows by suppressing natural hormonal fluctuations.
Stress and Lifestyle Factors: High levels of stress, excessive exercise, extreme weight loss, or certain dietary patterns can disrupt hormonal balance, contributing to lighter menstrual flows.
- Medical Conditions: Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders might lead to irregular and lighter menstrual flows due to hormonal imbalances.
Medium Flow: The Balance PointA moderate menstrual flow, characterized by a balanced amount of blood loss and a consistent use of regular tampons or pads or a Model 0 or 1 DIVA Cup, reflects more harmony between hormonal and anatomical factors:
Balanced Hormones and Average Endometrial Thickness: Moderate flow often results from a regular balance of estrogen and progesterone, ensuring a healthy uterine lining and an appropriate amount of tissue to shed.
- General Health: Maintaining good overall health through proper nutrition, moderate physical activity and minimizing stress can contribute to moderate menstrual flow and ward off menstrual conditions
Heavy Flow: The Complex DynamicsA heavy menstrual flow, marked by a significant amount of blood loss and the use of super or ultra-absorbent tampons/pads or a Model 2 DIVA Cup, could mean a combination of hormonal, anatomical, and health-related factors:
Higher Hormone Levels: Elevated levels of estrogen and progesterone can lead to a thicker endometrial lining, requiring more tissue to be shed and resulting in a heavier menstrual flow.
Larger Uterine Cavity: Individuals with larger uterine cavities may experience heavier flows due to the increased amount of tissue available for shedding.
Hormonal Imbalances: Conditions like fibroids, endometriosis, and adenomyosis can lead to hormonal imbalances that contribute to heavier menstrual flows.
Blood Clotting Factors: Disorders that affect blood clotting can result in heavier or prolonged bleeding during menstruation.
Inflammatory Conditions: Chronic inflammation of the uterus or pelvic region might contribute to heavier menstrual flows.
- Birth Control: Copper IUDs, which are non-hormonal, and some birth control pills, can lead to heavier flows.
Nutritional ConsiderationsIf you’re someone who loses a lot of blood every 28 or so days, eat plenty of iron-rich foods and monitor iron levels with your healthcare provider. Low levels of iron can cause excessive fatigue, headaches and dizziness, anxiety and depression, and cold hands and feet due to poor circulation.
Menstrual flow is influenced by a complex interplay of factors, ranging from hormonal fluctuations and uterine characteristics to lifestyle choices and health conditions. If you’re struggling with heavy menstrual bleeding, don’t hesitate to reach out to your health care provider.
Understanding the reasons behind light, medium, and heavy flows can provide insight into our reproductive and overall health and help us take charge of our overall well-being.
- Dasharathy, Sonya S., et al. “Menstrual Bleeding Patterns among Regularly Menstruating Women.” American Journal of Epidemiology, vol. 175, no. 6, 15 Mar. 2012, pp. 536–545, www.ncbi.nlm.nih.gov/pmc/articles/PMC3299419/, https://doi.org/10.1093/aje/kwr356.
- Donoso, Manuel B., et al. “Normality Ranges of Menstrual Fluid Volume during Reproductive Life Using Direct Quantification of Menses with Vaginal Cups.” Gynecologic and Obstetric Investigation, vol. 84, no. 4, 2019, pp. 390–395, https://doi.org/10.1159/000496608.
- “How Much Blood Do You Lose on Your Period?” Healthline, 30 May 2018, www.healthline.com/health/how-much-blood-do-you-lose-on-your-period#tips-for-symptom-relief. Accessed 18 Aug. 2023.
- “Light Period: What It Means, Causes, and When to See a Doctor.” Www.medicalnewstoday.com, 22 Nov. 2021, www.medicalnewstoday.com/articles/322935#causes.
- Mayo Clinic. “Menstrual Cycle: What’s Normal, What’s Not.” Mayo Clinic, 2016, www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/menstrual-cycle/art-20047186.