Heavy Menstrual Bleeding: How Much Is Too Much?

Collection of menstrural products on pink background

Many people don’t talk about their periods. However, there are lots of questions you might have. One common question is how much bleeding you can expect during your cycle. What is considered normal? How do you know when there is too much bleeding? We’re here to answer your questions. 

To get to the bottom of it, we reached out to Maureen Baldwin, M.D., M.P.H., an OB-GYN with a focus in adolescent gynecology, and Kristina Haley, D.O., M.C.R., who specializes in bleeding disorders. Together, they run the Spots, Dots and Clots clinic at OHSU Center for Women’s Health, where they see young people who often come in to address heavy menstrual bleeding. 

How do you know how much bleeding is normal?

Dr. Baldwin says her first question is to ask the patient about their own perception of their bleeding. Does it seem like a lot? Is it causing significant disruption to their daily life? She also looks out for certain red flags, such as: 

  • Does your period last longer than 7 days? 
  • Are you missing school or work because of bleeding? 
  • Do you need to get up at night to change products? 
  • Are you experiencing significant overflow or flooding? 

“You likely need to see a doctor, and maybe a specialist, if you are experiencing these symptoms,” says Dr. Baldwin. 

Dr. Haley adds that some may worry because they don’t begin their period on the same day each month. While some may experience their cycle onset like clockwork, she says that some variability is normal. 

“Having regular periods means having bleeding episodes about four weeks apart,” says Dr. Haley. Some irregularity is normal the first few years. 

Where to start with questions

It can be hard to know what normal looks like. For example, some bleeding disorders have a genetic component. Family members may experience excessive bleeding, but they assume it is normal because those around them have similar bleeding during their cycles.

Treatment for heavy bleeding

One of the primary means of treatment for menstrual regulation is hormonal medication. There are many myths surrounding hormonal medication. Drs. Baldwin and Haley share that: 

  • It is safe to take medications to suppress your period. 
  • Hormonal medication does not lead to infertility later in life. 
  • You don’t need a “big reason” to use hormonal medication to help with heavy bleeding or discomfort. 

There are other instances where you may need help with your period. Visit our other resources below and reach out to your provider if you have concerns.