Menstrual Blood Loss: What is Normal?

It shouldn’t be a secret, but because it has been kept one for so long, I continue to meet women with heavy menstrual bleeding (HMB) who don’t even know it yet, or have only been offered a Mirena or Tranexamic acid (TXA), with no discussion of root cause.

So here’s the deal:

  • 40-80ml of menstrual blood loss per month is ideal.
  • Anything greater than 80ml needs to be investigated.
  • The most common explanation is an imbalance of oestrogen to progesterone in the luteal phase of your menstrual cycle. This is especially relevant in teenagers, where the menstrual cycle is still maturing, and in women over 35 years of age, where progesterone begins in decline.

So, as I said in my The Importance of Cycle Tracking, start cycle tracking and if your blood flow is greater than 80ml, I suggest:

  • A mid-luteal progesterone and estrogen blood test.
  • A pelvic ultrasound to screen for other root causes including fibroids and polyps.

Let’s keep normalizing talking about our menstrual blood and please know almost all cases of HMB can be resolved without a Mirena or medication and certainly without a hysterectomy.

HMB? Please book a complimentary 15-minute consultation to learn more about how we can assist you today.

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