- What constitutes period blood
- How much period blood is there?
- Period blood color during menstruation – what it means
- The smell of period blood
- Bleeding during pregnancy – signs of early miscarriage?
- When to visit a doctor
It’s settled that it’s not black :) The majority of people associate period blood with shame and never-ending fear of leaking. Which is why many people deliberately refrain from physical activity during “the red days”. In numerous cultures menstruation is perceived as shameful and menstruating people are excluded from religious meetings or ceremonies. In less economically developed countries (such as India) the issue is also the access to protection and intimate hygiene products. This, in turn, is the catalyst of social and educational problems among the young.
What constitutes period blood
During the menstrual cycle the endometrium builds up extra layers in order to receive the fertilised egg and make nesting thereof possible. If fertilisation doesn’t happen, the upper layers of endometrium shed, causing the vaginal bleeding.
Menstrual fluid – not only blood
The menstrual fluid is composed not only of blood. When the endometrium thickens, it accumulates nutrients. Period blood is just one element of the menstrual fluid – which is also made of:
endometrial lining – it’s the shed layers of tissue in the form of clumpy clots which form after an unsuccessful attempt of the unfertilised egg trying to nest in the endometrium; although the passage of those might feel a bit uncomfortable, their presence is actually considered healthy;
vaginal and cervical secretions – during menses it’s perfectly normal that blood mixes with cervical fluid and they flow out together at the same time. All the secretions are made of water, sodium, and potassium. These contribute to maintaining the proper pH balance in your vagina, keeping all the bad bacteria at bay;
bacteria – it’s natural for bacteria to accumulate in your vagina around your period, as the vaginal environment becomes moist (which is what bacteria like the most). In the case of an imbalance between the good and bad bacteria, you might be susceptible to various infections. Normally, your vagina should be able to cleanse itself from the additional visitors. However, if that doesn’t happen, antibiotic therapy should do the trick.
How much period blood is there?
The internet is flooded with various kinds of information regarding the issue – some of which are not entirely accurate. Which is why we’ve decided to resolve the matter once and for all.
We already know that period blood is just one ingredient of the menstrual fluid, so it’s important to know exactly what we are trying to measure here. It’s estimated that the norm for one period is 100 ml of menstrual fluid which contains about 30 to 50 ml of blood. However, some menstruating people might experience heavy menstrual bleeding; in others – the flow is rather scarce. So there’s no one universal rule and something which is default for one, might not necessarily be a standard for others. Moreover, it might even suggest an ongoing infection or unusual anomalies – which is why it’s so important to listen to your body! The best way to measure the volume of period blood on our own is to use menstrual cups. This way it’s much easier to assess the amount of menstrual fluid coming out of our body than by trying to estimate it using pads, for instance.
Period blood color during menstruation – what it means
The color of period blood is an important factor in determining the health condition of menstruating people.
Different colors of period blood
orange – no worries! The blood mixes with the cervical mucus which sometimes makes the vaginal discharge bright orange. If it occurs during menstruation, it may be a sign of the embryo nesting inside your uterus and a sign of a possible pregnancy;
pink – this blood color usually indicates scarce menstrual bleeding, however, bright-colored blood might also be a sign of low levels of estrogen. There are various reasons: bad diet, polycystic ovarian syndrome (PCOS), or the beginning of menopause. People who are exceptionally active might also notice pink period blood because intense physical activity (and the accompanying fat loss) might contribute to lowering the levels of this particular hormone;
bright red – in the majority of menstruating people this is the blood color in the initial days of menses. It’s because it flows out rapidly from the vaginal canal. Bright red bleeding is usually a sign of appropriate functioning of the organism;
dark red – nothing to worry about; dark red blood is just a sign that it has spent some time in your vaginal canal and had time to oxidise. It might be the result of a somewhat thicker endometrium or slower rate of outflow;
brown – brown spotting might also occur in the initial phase of bleeding (that is, in the first days of period), as well as towards the end of your period. Period blood flows out even slower and remains in the birth canal for longer than in the case of dark red blood;
black – dark brown vaginal discharge or black period blood color doesn’t necessarily indicate an infection or hormonal imbalance. It’s usually blood that remained in the uterus for a long time. Sometimes, dark period blood colors are an indication of elevated levels of estrogen. If that’s the case, talk to your doctor because it might lead to some health issues;
grey – this is the color that should make you call your healthcare provider right away. It may be a sign of a bacterial infection and, in some cases, be indicative of miscarriage. In the latter case, the intensity of bleeding is of great importance.
Keep in mind that the color of your period blood might change during the cycle. Such changes are normal and, in the majority of cases, don’t require any medical intervention. However, if the period blood color raises your suspicion and menses looks different than usual, you might consider additional testing and consultation with your doctor.
The smell of period blood
Adequate hygiene is one of the most important issues during menstruation. Taking proper care of it makes the potential smell undetectable to our surroundings. So it’s worth monitoring not only the color but also the smell of your period blood. It might also be an indication of an ongoing infection. The menstrual fluid, in a healthy organism, might have a slightly metallic smell, which is perfectly normal. This stems from the fact that blood contains iron. Any other funky smell might be a sign of infection or result from inadequate intimate hygiene.
rotten odour – might appear when you use one pad or tampon for too long. You should remove the product from your body as quickly as possible and wash the intimate area with a gentle wash. Avoid any scented gels and other products filled with chemicals as they might change the natural pH of your vagina and cause unpleasant infections;
fishy odour – if noticed during menses, it merits a medical consultation. It’s one of the symptoms of bacterial vaginosis (BV) (which is often accompanied by itching and irritation of the intimate area);
salty sweat odour – usually related to inadequate hygiene. Keep in mind that the inside of the vaginal canal can cleanse itself, balancing the appropriate, acidic pH. Your responsibilities boil down to washing your vulva and the opening of the vagina daily. Note! Not only during periods! During menstruation it’s advisable to do it a few times a day. Intimate hygiene should be high on the bathroom priority list of every person with a vagina.
Bleeding during pregnancy – signs of early miscarriage?
In the first trimester of pregnancy light bleeding is quite common. However, here are some signs that you don’t want to miss out if you’re pregnant:
brown discharge – especially if it looks like “coffee grounds”. As mentioned above, this might be just old blood that remained in your vaginal canal for too long, but if in doubt, consult with your doctor;
bright red bleeding or clots – might raise suspicion, especially in the advanced stage of pregnancy;
the usual pregnancy symptoms fading away (nausea, breast pain).
If you're experiencing any of these symptoms, don’t wait, and contact your gynaecologist.
When to visit a doctor
Apart from the aforementioned anomalies related to the color and smell of period blood, it’s worth paying attention to its clarity and texture.
If your period blood is runny and the bleeding itself heavy, in some cases, it might indicate anaemia. Monitor your subsequent periods and if nothing changes, consult your healthcare provider to assess the potential deficiencies. Moreover, runny period blood might be a symptom of ovarian or fallopian tubes cancer;
blood clots in the menstrual fluid might be a symptom of uterine polyps, submucous myoma, or intramural fibroids, among other things; in some cases it might also indicate low levels of progesterone and elevated levels of estrogen. Usually, these aren’t health threatening changes. However, if the number of blood clots is significant, it’s worth running some additional tests;
if your period is mucoid and unusually sticky, don’t worry. As was said before, the menstrual fluid is composed of cervical mucus as well. Some people produce more mucus than others – so it’s not an anomaly or a disease;
if your period is irregular or disappears altogether, it’s worth consulting it with a gynaecologist.
Period blood is not always as black as it’s painted – literally! :) Artists and activists, such as Natalia Wieretienow, who creates her paintings with period blood, want to draw our attention to the unjust stigmatisation and tabooisation of menstruation. Remember: listen to your body, monitor it, and draw conclusions. We hope that our little compendium about period blood will help you feel more comfortable and will resolve doubts when your next period comes.