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What counts as heavy, when nobody can measure it

You do not need a number. You need the four or five facts a clinician will ask for.

Lesson 2 of 5

10 min Text

What this lesson says

  • Nobody measures menstrual blood loss in ordinary practice; it is judged by its effect
  • Soaking through a pad or cup in an hour for several hours running is a described marker of heavy bleeding
  • Passing clots larger than about the size of a rupee coin, and flooding at night, both count
  • So does missing work, school or travel because of it
  • Bringing a written record of two or three cycles is more useful than trying to remember in the room

This is general education. It is not advice about your own situation, and it does not replace seeing a clinician.

Written lesson.
  1. 1. There is no test that weighs it. In ordinary practice, heavy menstrual bleeding is defined by what it does to you, and that definition exists precisely so that a woman's own account is the evidence rather than something that needs confirming.
  2. 2. The descriptions clinicians work from are practical. Soaking through a pad, cloth or cup within an hour, several hours in a row. Needing to double up. Passing clots bigger than about the size of a rupee coin. Bleeding through to bedding or clothes at night. Changing protection more often than you can manage at work, in a classroom or on a bus. Planning your month around it, or cancelling things because of it.
  3. 3. Any of those is worth saying out loud, and saying it in those words is far more useful than saying the bleeding is heavy — because heavy means different things to two women who have only ever known their own.
  4. 4. Tiredness belongs in the same sentence. Losing that much blood month after month draws down the body's iron, and the result is breathlessness on stairs, a pounding heart, difficulty concentrating, and being cold when nobody else is. Women often attribute all of that to being busy. It is worth mentioning alongside the bleeding rather than as a separate complaint, because the two are usually one problem.
  5. 5. Before the appointment, write down the dates of your last two or three cycles, how many days you bled, roughly how much protection you used on the worst day, and whether you flooded at night. It takes five minutes at home and it answers most of the questions you will be asked.

All lessons in this course

  1. 1 What ordinary looks like, and how wide the range is 10 min
  2. 2 What counts as heavy, when nobody can measure it 10 min Reading now
  3. 3 What is usually behind heavy or painful bleeding 12 min
  4. 4 What gets checked, and why iron is in the first set of tests 11 min
  5. 5 What treatment is aimed at, and questions for your clinician 10 min

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