Sami’s period started earlier that day. It had been just two hours since she changed her pad, but it was time to change it already. “That was fast,” she mused as she pulled the stall door closed behind her. It was 8:30 am and she had a meeting starting in a building across her work campus at 9. 

Sami, 35, was surprised to have started this morning. She'd skipped a month, (or was it 2?). It happens sometimes, right? Frankly, she hadn’t been that aware she'd missed her period, with work taking off and all. But that surprise was nothing to the shock at the sight of so much blood, and already a clot or two. 

Could she have been pregnant and was now miscarrying? 

Nope. That was definitely not a possibility. There'd been no intimacy in her life for a while.

What else?

“Internal bleeding? Bleeding disorder?” Sami’s mind began to race and her breathing started to follow suit, a little shallower and faster. She did a body scan for pain or other out-of-the-ordinary symptoms. No… nothing else unusual.

She’d been to see her doctor for her annual screenings just a few months prior and had had a clean bill of health. 

“What else? What else could it be?” she asked herself as she took a deeeep breath and a slow exhale. 

Two unexpected words popped into Sami’s head: hormone change.

“I’m too young for that change to be starting." 

Her mom had been in her late 40’s when she started talking… well, complaining, really… of menopause symptoms. Mainly hot flashes, plus her mood went decidedly sour for about 5 years. Generations up the line on both sides never discussed it, and Sami had never directly asked.

Still. The shock in seeing so much more blood than usual stopped Sami cold. She never bled this much, even on her heaviest days, and this period had just started that morning.

So, what, exactly, was going on here?

Sami could very well be in the wee beginnings of perimenopause, and menorrhagia — heavy flow periods — could be a new experience. Time to talk to the doc.

When is it “menorrhagia,” specifically?

CEMCOR, the Centre for Menstrual Cycle and Ovulation Research, states that “menorrhagia, meaning blood loss of 80 ml or 16 soaked regular sanitary products or more per cycle, occurs in 25% of very early perimenopausal or early menopause transition women as well as in fewer adolescents and premenopausal women of any age.”

Some experience radically less blood loss than their “regular” period. If it’s less than 20ml, that may be considered a light period or light flow. 

It’s worth reinforcing that some people experience menorrhagia as part of their normal cycle. For some, very heavy bleeding is familiar and part of their normal courses; it’s been part of their cycles since their periods began. Controlling heavy bleeding may be as simple for some as taking ibuprofen on the heaviest days, and others may opt for an IUD. Both of these options, and any others, are best coming directly from your doctor.

For many, experiencing a very heavy-flow period is a brand new occurrence. And yes, if it’s not your usual, familiar “flow”... it can be a seemingly shocking amount of blood, (not to mention clots) that will pass. Best to get any new change checked out with your doctor, as new-to-you heavy flow may be a symptom of other conditions such as fibroids or polyps, endometriosis. The best idea always is to get it checked. 


Real coaching & support for your menopause journey: It's time for HealthFix. Review & subscribe.

How well do you know your “normal”?

No one experiences your period like you do. And no one else will know what constitutes “normal” for you, or what is “new” in your body better than you. This is simply a pitch for deeper awareness. You may not love the idea, but it can really help you navigate your perimenopause and menopause path if you cultivate a deeper awareness as new changes occur. It’s helpful to track exactly what, when, how much, and how intense the symptoms or changes are for you. 

Some have tracked periods religiously, others are surprised every time they start. Many fall somewhere in between the two. Whether it’s in a journal, on a tracking app (take your pick of many), or just a red dot on the hanging calendar for each day of your cycle, more awareness is better than less. 

How might you best track your periods?

Consider these few prompts: 

  • When did you start having periods?
  • Average number of days between cycles?
  • How long, on average, does a period last for you?
  • Does anything happen prior to your period to tip you off that it’s about to drop? 
  • Mood changes, perhaps? How many days before? How intense?
  • Perhaps a pinch about where one of your ovaries may be?
  • What else feels like a regular period for you? 
  • Cramps? How intense? How long do they last? 
  • Headaches? How intense? How long do they last? 
  • Sore or tender breasts? How sore? Is it more tender prior to a period or during?
  • And for all of these, what normally works to treat or soothe these symptoms before and during a regular period for you?

If you’re at a loss at first glance, that’s okay. Perhaps a little context could help: Ask family members what their periods are or were like and see if you can identify what a regular period is, and isn’t, for you in that discussion. 

For example, your regular periods may be radically different from your mom’s or sister’s, or friend’s periods. A little chat about it may unveil a lot of information.

If you’ve captured this, awesome! Why not send it along to your doctor’s office and have them put it in your file? Take a photo of it, have it handy for future appointments. And add to it as time goes on and new changes occur.

A surprising, but practical, thing to share with your doctor

Let’s go back to Sami: what can she do while waiting for a call back from the clinic or doctor? If possible, get as specific as you can about this period. Namely, how much blood are we talking about? Sami might track the number of pads she's going through in a day, and/or how fast a pad gets saturated. Sami might also note the color of the blood, the increase or decrease of clots as the period continues.

Same again if tampons are used. 

More accuracy for the “how much blood?” question can be gathered if you’re using a menstrual cup, as many have a measuring line. Note it or jot it down, and track the number of times you’ve emptied the cup through the course of your cycle.

Once Sami gets to the doctor and has a candid chat, her doctor may want to run labs, test for FSH levels, and ask for other details about what’s new or different in Sami’s life. The awareness Sami brings can level up the care and collaboration with her doctor.

Just in case

If your doctor dismisses or diminishes your experience of a startling increase or sudden heavy flow, consider whether or not you’re willing to engage with this kind of “care” moving forward. Your health, well being, and awareness are absolutely precious and worth real, good quality, compassionate care, and respectful attention.


What constitutes a “regular” period for you? Does heavy flow figure in? Or no? Read, review, and share in the Gennev Community Forums today.



Shannon Perry

March 10, 2020
Director of Programming & Media

Medically Reviewed By

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