Paying attention to how you’re bleeding is a good way to find out about other health conditions in your body,” explains Leah Millheiser, MD, an ob-gyn and director of the Female Sexual Medicine Program at Stanford University. Here are the main bleeding patterns to look out for during your cycle—plus what each one may reveal about your overall wellbeing.
1. If your period blood is bright red…
A bright red color—as in fire-engine-truck Bright red blood often means that you are simply at the beginning of your cycle. “The fresher the blood is, the more red it’s going to be,” explains Millheiser.
But while the color is no cause for alarm, the fire-engine-truck stain it can leave on your clothes is a whole different story. Stay prepared by stocking up on Totally Spot-less powered by Clorox2. It’s specifically designed to work magic on “feminine stains” by pretreating them and then removing the stains during washing. Bonus: It works on wine, sweat, coffee, and tea stains, too.
2. If your blood is brownish…
After you’ve had your period for a couple days, the blood may start to transition from bright red to a darker, brownish hue. And while it’s easy to jump to conclusions and assume that a switch of any kind indicates trouble, it’s actually all good, Millheiser says. “Brownish blood is basically just older blood that’s been in your uterus for a lot longer than fresh blood. It’s had a chance to oxidize, so it’s not as bright,” she adds.
Another reason your period blood may veer toward the brownish side is if you have an IUD—especially the progesterone kind. With an IUD, “you’re shedding a smaller amount of the uterus lining every month, which means that the blood stays in there for a lot longer,” says Millheiser. Even though the blood may be a little more subdued, it can still stain your clothes—which means that Clorox2 Totally Spot-less is your best friend in this scenario, too.
3. If you’ve got some clotting…
Blood clots—i.e., those thick blobs of blood that can appear during your period—are generally not too worrisome. They’re simply a function of your bleeding, says Millheiser, and as long as they don’t happen all the time and they’re under the size of a quarter, you’re probably fine. But if you have large clots on a regular basis, they could be indicative of a larger problem.
“Women who cast large blood clots generally have very heavy periods, which means they could have hypothyroidism, uterine fibroids, symptomatic anemia, or menorrhagia, which is the scientific term for very heavy bleeding,” Millheiser says. At the same time, large blood clots could also mean nothing at all. “Sometimes there is no cause. Sometimes it’s just how a woman’s body functions,” she says. Your move: If you feel that you are passing large and consistent clots on a regular basis, rather than the occasional clot here and there, talk to your gyno. There may be a bigger issue going on that you two can investigate—and fortunately, there are many treatment options available.
4. If your cycle is irregular…
Again, as with most things period-related, irregular periods may be totally normal for you. But there are also many factors that could be causing your irregular flow, all of which are worth investigating. For starters, stress could be a big culprit here. “When you’re stressed, your body produces more cortisol, i.e., the stress hormone. Elevated cortisol levels can block the signals that lead to the release of an egg that then leads to your period—so your period may come late, or you may skip it altogether,” Millheiser explains.
Another reason: You could have polycystic ovary syndrome (PCOS), which is a mild (and manageable) hormone disorder where you develop elevated levels of the male sex hormone androgen, causing increased hair growth and weight gain. “Women with PCOS don’t ovulate every month, which means that they may not get a period every month,” says Millheiser.
Also, if you’ve had any sort of medical procedure in your uterine cavity—like an abortion—it may be harder for the blood to come out due to scarring. And finally, if you’re an intense athlete, you may have an extremely light or absent period because your body isn’t producing enough hormones. Talk to your gyno to figure out the best action plan for your bod.
5. If you have really bad cramps…
Cramping can be mild in some women and severe in others—it really depends on the individual. When your uterus contracts to shed its lining during your period, it releases hormone-like substances called prostaglandins—and the more of those that your body releases, the more painful your cramps will be, explains Millheiser.
But what can your cramps tell you about your overall health? It depends. Sometimes, a cramp is just a cramp. But if they are incredibly painful, they could be a symptom of endometriosis, which occurs when cells that normally line the inside of your uterus grow outside of it, too. That misplaced tissue thickens, breaks down, and bleeds every month “because it’s responding to the same signals that cause you to have your period in the first place,” explains Millheiser. If your cramps are incredibly painful, talk to your gyno to figure out what’s going on.
6. If your flow is pretty heavy…
The thing about labeling your period as “heavy” or “light” is that the definition varies depending on the person—meaning it’s hard to quantify. That said, generally speaking, if your flow is longer than seven days and you have to change your tampon every two hours or so, you are probably bleeding on the heavier side, says Millheiser. On the one hand, that can mean absolutely nothing aside from the fact that you are a person with a heavier period. But it can also indicate some other health conditions you may need to address, such as hypothyroidism, adenomyosis, fibroids, or Von Willebrand disease—a bleeding disorder that slows the blood clotting process and leads to prolonged bleeding—so you may want to talk to your gyno either way.
Another piece of info to keep in mind: Certain medications can affect the type of bleeding you’re experiencing, too. “Non-hormonal, copper IUDs can cause your period to be heavier, and certain birth control pills and the Depo-Provera shot can change the way you bleed, too,” Millheiser says. If you’re concerned, your doctor will help you figure out what’s up.