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Does your period flow like the river Nile? Do you often double up with tampons and liners? Is your purse stocked with “super absorbency” feminine care products? You, my friend, are plagued with heavy periods.

But good news: You’re not alone.

It’s completely normal for your period to be heavy for a day or 2. Heaviness that seems to go beyond isn’t all that uncommon either, and it can have a bunch of different causes.

If you’re not sure what’s going on down there, keeping a log to track your flow can help you decide whether you should talk with your doctor or if it’s just a monthly annoyance.

So, what exactly should you be looking for? Here’s how to tell a typical heavy day from something a little more dramatic. Plus, what typically causes very heavy periods and what you can do about it.

First, let’s recap real quick how periods work in general. Each month your body prepares for a potential pregnancy by lining your uterus with blood and tissue. If no pregnancy occurs, the blood and tissue are shed in the form of your monthly period.

So, what constitutes a typical flow versus a heavy one? Keep in mind that every woman’s periods are different. While it’s normal to have some heavier and some lighter days, your normal might not match up with someone else’s.

What’s usual for you can change over time too. Birth control pills and IUDs can make your period lighter or heavier. Your periods can also change after having a baby and again as you get closer to menopause.

Even with all that variation, very heavy periods can be abnormal. Menorrhagia is a condition where your period goes on for more than 7 days or the flow is super intense. That might mean you:

  • soak through one or more pads or tampons per hour for several hours in a row
  • need to change your pad or tampon in the middle of the night
  • need to double up on pads
  • pass blood clots that are bigger than a quarter
  • have constant or intense abdominal cramping during your period
  • avoid doing the things you normally do because your period feels too heavy
  • feel tired, sluggish, or out of breath during your period

Certain health factors can also cause your periods to become heavier. Some of the things that can cause a heavier than typical flow include:

  • Certain birth control. Copper IUDs in particular can lead to heavier periods.
  • Uterine fibroids. These harmless growths are common, but they can make your period heavier.
  • Hormonal conditions. Polycystic ovary syndrome (PCOS), for instance, can cause you to skip periods or have heavier ones.
  • Bleeding disorders. Like platelet function disorder or von Willebrand disease.
  • Medications. Including anti-inflammatories, anticoagulants, and some hormonal meds.
  • Other health conditions. Like liver, kidney, or thyroid disease, pelvic inflammatory disease, or some cancers.

Your flow probably isn’t uniform throughout your entire period, and that’s totally normal. It’s fine to have some heavier days, especially toward the beginning.

Bleeding that’s heavier but still on the normal side might look like:

  • Having to use a super absorbent pad or tampon for a day or 2, especially during the first day or 2. You might also have to change it more often.
  • Heavy bleeding that’s bright red, brown, or even black. Your blood might start out bright red and turn darker, or start out darker and turn lighter. Darker blood is often a sign of older blood or tissue, but it’s usually nothing to worry about.
  • Thick, jelly-like chunks or clots. Clots are a mix of blood and tissue, and they’re a totally typical part of your period. It’s normal for clots to be red, brown, or black. Some might be smaller and some might be bigger, but as long as you’re not regularly passing clots larger than a quarter, they’re nothing to worry about.

Heavy periods aren’t automatically a problem. But if they’re interfering with your daily life, there are definitely things you can do that’ll help you cope.

Heavy periods are also worth addressing if you feel like they zap your energy, since fatigue or sluggishness could be a sign of iron-deficiency anemia.

At-home remedies for heavy periods

Feel like your heavy days leave you totally wiped? There are things you can do to help get your energy back up, like:

  • Eat iron-rich foods. Adequate iron helps you stay energized, but your levels can drop when your period gets heavy. Aim to get the recommended 18 milligrams daily during your cycle and throughout the rest of the month. Fortified cereal, beef, chicken, turkey, fish, beans, leafy greens, and dark chocolate (YES!) are all good sources.
  • Stay hydrated. Drinking enough water can help stave off that weak, lightheaded feeling. Consider steering clear of alcohol, which can have a dehydrating effect.
  • Take comfort measures. Ibuprofen or a heating pad placed over your belly can both help ease abdominal cramps.

Heavy period treatments to talk with your doctor about

If at-home measures aren’t getting the job done, your doctor might be able to recommend other options. These could include:

  • Iron supplements. To help replenish the iron lost during your period.
  • Birth control pills or hormonal IUDs. Both of these can help lighten your periods.
  • Surgical procedures. Such as endometrial ablation or fibroid surgery.

A few heavy days here or there probably isn’t a big deal. But you should talk with your doctor if your period is consistently very heavy or if the heavy bleeding is accompanied by other symptoms, since those could signal an underlying health problem.

Let your doc know if you experience:

  • periods lasting longer than 7 days
  • periods where you soak through more than one pad or tampon per hour for several hours
  • periods where you pass clots larger than a quarter
  • periods that leave you totally wiped or otherwise affect your quality of life
  • bleeding in between your periods
  • bleeding after menopause

You should also talk with your doctor if you have signs of a potential underlying condition that’s contributing to the bleeding.

For instance, both uterine fibroids and endometriosis can cause severe abdominal pain or cramping, painful sex, severe bloating, or painful urination.

One last thing to keep in mind: Miscarriages can also cause heavy bleeding, and often, they happen so early on that a woman doesn’t even realize she’s pregnant.

Bleeding or spotting, vaginal discharge or large clots, severe cramping, and back pain are all potential signs, especially if the symptoms strike at a time when your period isn’t due.

If you think you’re having a miscarriage, let your doctor know. Together you can decide on the best treatment option.

tl;dr

Everyone’s periods are a little different, and a day or 2 of heavier bleeding is normal. But you should let your doctor know if your bleeding seems excessive, goes on for longer than 7 days, or is accompanied by other symptoms. They can help you figure out whether you’re dealing with something outside the realm of normal and the best way to manage it.