Understanding Menstrual Bleeding

Understanding Menstrual Bleeding

Many women feel they should already “know” their bodies—but the truth is, menstrual health can still be confusing, especially when your period doesn’t follow the “normal” textbook rules. As a gynecologist, I often see women who are unsure whether their bleeding is normal, heavy, irregular, or something to be concerned about.

Let’s break it down in a way that makes sense—for your body, your age, and your peace of mind.

Normal Menstrual Bleeding

• A normal menstrual cycle:

• Lasts 21–35 days from the start of one period to the start of the next.

• Bleeding lasts 2 to 7 days.

• Blood loss is usually 30–80 ml (about 2–6 tablespoons).

• You change pads/tampons every 4–6 hours without soaking through.

When Is Menstrual Bleeding Not Normal?

Heavy Bleeding (Menorrhagia): Needing to change a pad/tampon every 1–2 hours, passing large clots, or bleeding for more than 7 days.

Irregular Cycles: Bleeding that’s unpredictable, comes too frequently (less than 21 days), or is too far apart (more than 35–40 days).

Spotting Between Periods: Especially if it’s frequent or not related to hormonal birth control.

Painful Periods (Dysmenorrhea): If cramps are severe enough to limit your daily activities.

Post-sex Bleeding: This should always be evaluated.

These can be signs of conditions like polycystic ovary syndrome (PCOS), fibroids, endometriosis, thyroid issues, or even hormonal imbalances.