Well, you've got 37 responses on non-hormonal-BC flow, and 19 responses on hormonal-BC flow. That's 56 women, and while the results are interesting, that's a tiny sample size. Additionally, you're asking a small subset of the population: women who live in the developed world and have computer access (i.e. richer than most of the world's population and living a certain lifestyle) AND who use a relatively obscure method of dealing with menstrual flow.

While I don't know exactly how our group would skew the results, at least one guess I'd hazard is that many of us have heavy enough periods that we pay attention to them and consider more effective ways to deal with them. Maybe cup users have more heavy periods than average? Or maybe because many of us live in societies with higher technical advancements, we're exposed more to industrial pollutants and artificial hormones, and therefore bleed more than a woman living in a remote bush village?

I suspect the cup users have heavier periods theory is probably right. Unfortunately, we're the only ones who can measure.

It's still interesting that so few of us fall in the under 90 ml categories, though - because officially, above that is menorrhagia, yet only 2-6 of us experience the symptoms. I'm thinking that figure is Just Plain Wrong.

Well, I guess tampon users could get their digital kitchen scales, weigh a dry tampon, then re-weigh after removing it...yeah, unlikely to happen. Oh well!

I technically fall into the menorrhagia category, though it's mostly concentrated in one day when I fill my cup every 2 hours for most of one late morning/early afternoon. But I don't *feel* menorrhagic - I'm not irregular or in constant pain (my cramping is limited to one morning before I even start bleeding, and that's WITH a copper IUD).

I think you may be on to something - perhaps there should be a redefinition of "menorrhagia." Because it seems clear that many women bleed heavily enough to be menorrhagic without the symptoms, perhaps there should be a division between menorrhagia that is confined to heavier-than-normal bleeding (and which, in my case at least, is generally benign), and pathological menorrhagia that is causing other symptoms and is disruptive to one's lifestyle.

well, I just took the trouble to look up the answers.

Every single person who answered 'yes, dianosed' or 'I think so' bled over 180ml, except one 'I think so' who put herself down as 150-180ml.

Ho hum.

Methinks 80ml is just a serious underestimate, in the sense of 'about half of the real figure'.

I wouldn't consider bleeding in that (80ml) area to be 'heavier-than-normal'. It's well within the happy bell shaped curve thing. 'Above average' I could accept :) since that's roughly half the population. Hehe.

i bleed very little.

i estimated that i have bled about 30-40 ml this period.

i left in my cup for 12 hours, and it wasn't even half full.

however, i really like my cup. and, my pads used to leak (until i switched to home made cloth ones)

eeenteresting. They've only ever leaked for me due to just, well, overflowing. Do you get all those 30-40 mls in a very short time?

Maybe I'm just biased because the reason I personally was drawn to the cup was because it holds more fluid, to help me cope with the bleeding all over the place business. I doubt it'd have that much appeal if pads could cope fine.

over about 3-4 days.

i suppose this might not be as accurate, as i'm just estimating.

My lightest day, I bled about 3 ml all day. I bled about I got about 3-4 ml every 6 hours (on my heavy day) and about 5 ml in 12 hours on my 3rd, medium day. Today, my fourth and final day, I just have spotting, so it isn't even worth it to wear a cup. Sometimes, I don't even wear a pad, and there will be like one or two drops on my underwear.

actually, that would make me only bleed like 25 ml.

so i think that my 30-40 was an overestimate. now that i'm breaking it down.

yeah. I've never made it past the 7.5 ml line...

so i guess maybe i bleed less than i originally thought. maybe I can collect all of it next time and measure it out. but that might get icky if left out, right?

The poll was started just after my last flow, and I'll be starting again the middle of next week - I can't wait to post my results too! ^_^

I wonder if it's because a lot of what ends up in the cup is cervical mucus, not blood? That's one reason why I find it tricky to guess how much I'm bleeding. I'm on my period now, so I should really pay attention.

This is what I'd suggest for the poll, let me know what you think.

___________________________________

1. What form of birth control do you use?

* no contraception/barrier methods alone/FAM
* combined hormonal contraception (the standard Pill, Nuvaring, the patch)
* progestogen-only contraception (the mini-pill, Depo Provera [injection], Mirena [hormonal IUD], the implant)
* copper IUD (no hormones)

2. If you are not using contraception/using barrier methods alone/FAM, how much do you bleed over one period?

* less than 30 ml of blood (less than one full cup)
* 30-60 ml (1-2 full cups)
* 60-90 ml (2-3 full cups)
* 90-120 ml (3-4 full cups)
* 120-150 ml (4-5 full cups)
* 150-180 ml (5-6 full cups)
* 180-210 ml (6-7 full cups)
* 210-240 ml (7-8 full cups)
* 180 ml or more (more than 8 full cups)

3. If you are using combined hormonal contraception (the standard Pill, Nuvaring, the patch), how much do you bleed over one period?

* less than 30 ml of blood (less than one full cup)
* 30-60 ml (1-2 full cups)
* 60-90 ml (2-3 full cups)
* 90-120 ml (3-4 full cups)
* 120-150 ml (4-5 full cups)
* 150-180 ml (5-6 full cups)
* 180-210 ml (6-7 full cups)
* 210-240 ml (7-8 full cups)
* 180 ml or more (more than 8 full cups)

4. If you are using a copper IUD (no hormones), how much do you bleed over one period?

* less than 30 ml of blood (less than one full cup)
* 30-60 ml (1-2 full cups)
* 60-90 ml (2-3 full cups)
* 90-120 ml (3-4 full cups)
* 120-150 ml (4-5 full cups)
* 150-180 ml (5-6 full cups)
* 180-210 ml (6-7 full cups)
* 210-240 ml (7-8 full cups)
* 180 ml or more (more than 8 full cups)

5. If you are using progestogen-only contraception (the mini-pill, Depo Provera [injection], Mirena [hormonal IUD], the implant), how much do you bleed over one period?

* less than 30 ml of blood (less than one full cup)
* 30-60 ml (1-2 full cups)
* 60-90 ml (2-3 full cups)
* 90-120 ml (3-4 full cups)
* 120-150 ml (4-5 full cups)
* 150-180 ml (5-6 full cups)
* 180-210 ml (6-7 full cups)
* 210-240 ml (7-8 full cups)
* 180 ml or more (more than 8 full cups)

6. Do you consider yourself to have menorrhagia [link as before]?

* Yes, diagnosed by a doctor
* I think so
* No

_________________________________________

Things I've changed from the original:

* I've increased the amount of blood loss, since it looks like many of us are bleeding more than we'd originally expected.
* I've moved the question about form of contraception to the top
* I've broken the categories down a little further, so that the hormonal contraception is divided up into the two main types, and copper IUDs are added. Not perfect, but it's a start.

Is it worth putting a line in at the top about how cup capacity does vary slightly, and it's worth getting out the measuring spoons and checking your own cup if you can, so that you have an idea of how much you're actually filling the cup? I mean, I know that there's a certain level where my blood most often comes to, but I'm really not sure what that is in ml.

Oh, and I've added FAM (Fertility Awareness Method) to the first category. Is pretty much every form of contraception covered now?

well, er, the last one obv needs to be changed from '180 ml or more' to '240 ml or more'.

I don't know whether we need a get out option for each? is it mandatory to vote on all questions? I assumed it was when I wrote the original (with the 'this is not my method of bc' option).

Apart from that, all good. If you want to add a note about people measuring then okay - btw I did check my cup against the syringe and it's exactly 30ml to the brim. (Mooncup, smaller size, and to just under the holes was 15ml). The Diva has measuring lines, so that's okay. Dunno about the keeper/other mooncup size.

*smacks head* Yes, more than 240 ml. Glas someone was watching!

It's not mandatory to vote on all questions. Perhaps we should put in a note at the top saying that, that you can just skip to whichever section applies to you? If you put in an answer for "this is not my method of birth control", it skews the results because then you can't look at it and say, "Ah, 13% of people on Method A are bleeding 6-7 cups."

Hey, I want to resurrect this - what do you think?

What symptoms are associated with menorrhagia besides heavy menstrual flow? I'm not aware of any. (Well, painful menstruation, but that technically qualifies as dysmenorrhea, doesn't it?)

And I read somewhere... I'll try to find a link... that 80mL is the average amount of blood loss during menstruation. It doesn't include other uterine fluids or tissues.

I suspected that, but honestly, what are we meant to be doing, filtering our blood?

I believe that menorrhagia, by definition, is heavy menstrual flow. I was wondering what the "other symptoms" might be as well. I imagine that women with menorrhagia will also be more prone to cramping and PMS, but that's not the same as their being symptoms of menorrhagia.

you make a very good point.

I meant stuff like this:

http://www.mayoclinic.com/health/menorrhagia/DS00394/DSECTION=2&

But you're right that menorrhagia by definition is just heavy bleeding. I just thought it meant abnormally/dangerously/ at the very least inconveniently heavy bleeding, which 90ml doesn't seem to be.

I think it's all a subsection of heavy bleeding (e.g. it's inconvenient because you have to keep changing your menstrual products, which is purely because you're bleeding heavily) or things that tend to accompany heavy bleeding anyway (such as cramps), or are a result of heavy bleeding (anaemia).

As for what's abnormal, hah, that's almost a silly question, as it seems from our poll that loads of us are in the "abnormal" range, which is unlikely. More likely the figures somewhere, ours or theirs or both, are wonky. For what's considered dangerous, I'd think that would be more easily measured. At what level of flow are you pretty much guaranteed to have substantial anaemia, for instance?

Aha. Let's add another question:

Are you anaemic? (with suitable link so that they can look up the symptoms and say, "Er, I think I should get a blood test, that looks like me")
* Yes, diagnosed by a doctor
* I think I may be
* No

or will this be more difficult to measure because it's diet-related and also some people take mineral supplements? "Are you anaemic as a result of your menstrual flow?" and include the option "Can't tell due to dietary factors"?

I didn't know I was anaemic until I had a blood test. Didn't have any of the symptoms (tiredness etc) although I'm extremely pale <shrugs>

Of course, then I went on the pill and started having heavy periods monthly instead of every three months or so, and then the symptoms began to show, oh yes... <remembers Fainting Fit Of Doom> eck.

I'm not sure that's a useful question, really. There are so many other reasons for anaemia (my brother is, for eg) and lots of people won't know that they're anaemic, or people may be anaemic due to not eating food with enough iron.

Hmm. I already realised that a response to an anaemia question would be fairly hit and miss, I was just curious to see if you'd get any useful pattern emerging regardless (for those who can be bothered to analyse the results). For instance, you might find that once you get into, say, the top two categories of blood flow, suddenly everyone says they're anaemic. Do you think it's going to be too muddled even to give it a try?

I'm always ready to do that for the purposes of procrastination :)

and there's no harm in asking I guess. Shame we don't have thousands of people reading this :)

I think this community has nearly a thousand members, actually. No idea where they've all sprung from, it seems to have snowballed.

Just a fun wrench in the anemia question.

I'm the one who bleeds what I just realized is a half litre every cycle. I am quite possibly the most un-anemic woman ever. I get tested virtually every time I switch doctors and/or donate blood, and I donate blood quite often.

Not saying you shouldn't include the question. Just saying, like you'd guessed, that results might be confounding.

If 80 mL blood loss is the top end of normal, then yes, the second poll seems more accurate. One would have to have a significantly higher total fluid loss to qualify as having menorrhagia. I don't even know what that number would be, specifically, and I wish I could find a source that mentioned total fluid, but I can't, really.

This, though, was interesting:

Menorrhagia is defined as a menstrual period accompanied by a blood loss of greater than 80 to 90 mL. A history of excessive menstrual bleeding (i.e., large volume, flooding, passage of clots and heavy use of tampons) is often a poor indicator of the actual amount of bleeding. Only two-fifths of the women who complain of excessive bleeding actually have a menstrual blood loss of greater than 80 mL per menstrual period. From American Family Physician.

And this, while probably not scientific, is interesting:
Average Menstrual Flow
Approximately 50 to 175 cc., or one-quarter to one-half a cup. From Sexual Averages.

If this last site is correct, though, it would mean that a lot of women with fluid loss in the 5-6 cup range aren't very abnormal at all.

5-6 menstrual cup range

The idea of losing 5-6 cups of blood as in American measuring cups, the sort you measure flour and sugar with, is distinctly alarming.

True.

Although to me, the idea of losing only 1/2 to 1 American measuring cup of menstrual fluid (blood + other) is removed from reality.

Only two-fifths of the women who complain of excessive bleeding actually have a menstrual blood loss of greater than 80 mL per menstrual period.

Whereas we seem to have it the other way round: lots of us are bleeding more than 80 ml according to our measurements, but not many of those think it's excessive bleeding.

I still reckon our estimates are going to be fairly imprecise. I had a better look at the contents of the cup when I changed it today, and I think I wildly overestimated how far up the cup my menstrual fluid reaches when I was guessing last week. Which makes sense, as I think I'm a light bleeder.

And here today, I tried to go 4 and a half hours in my Diva instead of my usual 4. I removed an utterly full cup, plus had a fun goosh of blood run onto my hand. :)

I could quite possibly leave mine in for entire period without its overflowing, no wonder you find the idea of losing only 1/2 - 1 American measuring cup to be removed from reality!

Do you think we've gone high enough in the poll? I'm probably in the first category, possibly the second, so it's really hard to guess from my end of things.

Hmmm... I waited to answer this until I'd finished - or rather, nearly finished - another period.

I just emptied my 25th full Diva Cup. (Though I've had a couple overflow, I've had no partially full cups this cycle.) I haven't gotten out my measuring utensils, but even if a Diva only holds, say 20mL instead of 30mL, then I'm at roughly 500mL for my cycle.

I should point out that, yes, I did have an IUD inserted just over 3 months ago, so yes, this is a ParaGard adjustment period. However, I've been measuring my menstrual fluid loss since I got my Diva... wow, it will be 2 years now in January. I generally empty 25-30 full Divas, so even if I fill another cup on my cycle (unlikely), I'll still be at the low end of average.

My uterus is crazy.

bloody hell.

Ooops. Er. Yeah. But woah.

Remind me to never even consider an IUD <shudder> are you expecting them to get better?

No. Let me clarify. My periods have not gotten more bloody since getting my IUD. In fact, if anything, they may have gotten less bloody.

Though I really don't feel I've had enough IUD periods (I've had 2) to suggest that my flow is truly getting lighter, I can definitely say that the amount of blood I'm talking about totally happened when my uterus was just my plain old regular uterus. :)

haha I've had that.

ok, this is an old thread, but I wanted to add a comment....

I normally use a mix of both my cup and cloth pads, but I measured one whole period with cup only so I could measure my flow.

On my first and second days I believe I overfilled my cup 3 times each day.... because when I put my finger on the rim of the cup to break the seal, I got a lot of spillage, more than would happen if the cup was filled to the rim only.... so I'm sure it went past the rim (and I've had that happen since too).... I imagine by about 5mls (there was a lot of spillage). But even if you take it to be at the rim (which is 33mls in the Lunette), for those 2 days that's around 100mls a day! Then I had another 2 days of bleeding, which was harder to measure, perhaps 1 1/2 cups over 24 hours, then just what I'd call spotting....so I didn't use my cup.

So that puts me at about 230mls - 250mls I believe.

Which I find frightening when I read websites talking about 80mls and over being excessive and can lead to anemia.... I'm glad I found this thread, as I feel more normal now :)

I can't say for sure, but it seemed to be a "normal" period to me, and I've worn my Lunette on heavy days since and fill it 3 times a day for the first 2 days, so it seems to be at least consistently over 200mls. The only difference with wearing the cup full time was a shorter period by about 2 days.

I normally bleed for about 7 days, with about 5-6 weeks inbetween... which has been my cycle since I was a teenager. I've never had a 28 day cycle, always longer. I must admit, I do have irregular periods, which I consider is due to stress, when I am highly stressed I'll often skip a period, and I have before skipped a couple of months in a row. I'm not on birth control at all, and basically never have been (I do remember for a brief time being on them when I was a young teenager. To try and lighten my periods for memory - but they caused worse cramps, so I went off them.)

I had a blood test around the same time I measured my flow (for something unrelated), and my iron levels were fine. I do eat a lot of red meat though. So anemia is not a problem for me.

My mother has also had heavy periods, and has been complaining about it for a while, though no way to measure what it actually is (She refused my offer of the cup to measure).... and she does have problems with anemia (they eat hardly any red meat)... so she'd had to look into medical ways to reduce her periods.

But because mine have been like this for ages, I have no cramps, iron levels seem fine - I don't consider them to be a problem....

So I can't see how, with so many of us being well over 80mls consistantly, how those measurements can be accurate.

One website I read said that they test by taking the pads and soaking them in a solution, then extract the hemoglobin from that (I think that is what they did)... which would presumably not be the same as simply weighing a pad and calculating the loss or measuring it in a cup. But other sites I've read indicate that they do just weigh used pads.

Hey! :) Thanks for commenting, reminded me that I should really post the new updated version of the poll we discussed. When finals are over, anyway. Aww, since this was posted, my periods have changed a lot. I only get a couple of heavy days. Thank heavens for the pill, it's nice to not be completely out of it for a week :)

Well, you're definitely in the higher range. If it's not leading to any problems, though, then I would assume you're fine. From what I managed to work out, the 80ml type statistics could refer to blood rather than fluid. And from a little research, menstrual fluid is roughly 50% blood, so that might be what's going on. Or, really, it might not - those figures don't really fit our statistics either. I don't really know any more, it's been a while. Please, if you feel like wandering around on pubmed and looking things up, do tell me what you come up with.