Heavy menstrual bleeding is a serious health condition. Only now are we starting to understand what causes it – and how it can be treated. From the age of 12-13 onwards, Michelle Alston slept off the worst days of her menstrual periods in the school nurse’s office, battling severe pain as she bled through period products.
“I was taught that this is just normal,” she says. “This is just something that you have to learn to cope with.” She felt weak, failing to cope with her periods as well as her peers seemed to. It wasn’t until she reached her early 40s that she learned weakness had little to do with it – her periods were unusually heavy.
When bleeding during periods is so extensive that it interferes with quality of life, doctors call it heavy menstrual bleeding, and it’s a serious medical problem. Studies of populations from around the world estimate that between 10 and 30% of reproductive-aged women experience heavy menstrual bleeding like Alston’s. And due to under-reporting and a general lack of understanding of how much bleeding is too much, studies suggest it may actually occur in half of all reproductive-aged women.
Heavy menstrual bleeding can also signify other health problems and have serious consequences when unchecked, such as anaemia. Yet, only recently have researchers began exploring the resulting harms from heavy menstrual bleeding in depth, pursuing better diagnostics and treatments. A search of PubMed (a database of biomedical research publications) for the term “menstrual blood” yielded just 400 publications in the last decade.
Publications for “semen”, for instance, number over 15,000. “Women are probably owed years, if not decades, of research,” says Jackie Maybin, a gynaecologist at the University of Edinburgh in Scotland and programme director of The Missed Vital Sign, a research initiative for heavy menstrual bleeding. “And I think the time is now.” How much blood is too much?
For researchers, heavy menstrual bleeding is blood loss of over 80ml per cycle, blood clots exceeding the size of a US quarter, or periods lasting beyond seven days. But for those of us who menstruate, there’s no standardised or metric conversion for the practical ways of measuring bleeding: the number of bathroom visits, pads or tampons changed, or bloodstained pairs of underwear. Some clinicians try to meet patients halfway, asking them to judge their blood l…
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