How much rule is too much rule? Is having clots normal? Learn everything about your menstruation and the warning signs. 

The smell, texture and amount of menstrual flow: what is normal?

We have already seen in the previous article how complicated it is to know the female anatomy, and specifically, the menstrual cycle and all its possible variations. 

If you have doubts about the color that your period can take, in this article we will tell you what menstrual colors are normal, and which ones require a visit to the gynecologist. 

In this article we will review everything about the smell of menstrual blood, what causes the changes that you can experience throughout the month and the amounts that are considered physiological and those that are not. 

What is a menstrual period? 

But let's go back: what is a menstrual period? It consists of the detachment of a unfertilized egg, blood, and tissues of the uterine lining. It is completely normal for this combination to have a slight odor after leaving the vagina. The odor is more likely to be related to vaginal substances than to other elements of menstruation. Bacteria in the vaginal area and acidity can play a role. A slight metallic smell of iron and bacteria could be perfectly physiological.

What does the rule smell like? 

Menstrual blood does not smell bad and is not dirty. However, it is true that it tends to have an unpleasant odor after it has been in contact with the air for a long period of time. If you think your period tends to smell, try changing your pad, tampon or menstrual cup more frequently. 

When the period smells bad

In these cases we usually talk about a "gym" smell, sweat, onion or salt. These are probably caused by not maintaining good hygiene during the menstrual cycle.

Sometimes an infection can also make menstrual blood smell bad. If the smell is difficult to tolerate and is accompanied by abdominal pain, severe cramps, fever, intense flow with thicker blood clots or excessive vaginal discharge, you should see a gynecologist. A 'stale fish' odor is usually the result of growth excessive normal vaginal bacteria or to forgetting a tampon in the uterine cavity. In any case, it indicates a bacterial problem for which it will be advisable to visit the doctor since it is treated with antibiotics.

Although the exact cause of this is unclear bacterial overgrowth, known as bacterial vaginosis, seems to be more common among women who are sexually active and among those who douching or postcoital vaginal showers. Deodorizing products, such as wipes and aerosol sprays, are also not recommended due to the potential for irritation. Scented tampons should be avoided as well as plastic or poorly breathable fabrics. It is better to use unscented products, made of cotton fabric and breathable underwear, also made of cotton.  

Different types of smell:

Menstrual blood with a metallic odor

Coagulated blood may have a metallic odor, like a copper coin. This is typically due to the presence of iron in the blood and is not usually a cause for concern. However, it should not persist much longer after the period is over.

Flow that smells rotten

This type of odor is often due to a foreign body in the area, either a bacterial colonization or a forgotten tampon in the vaginal cavity. 

smell of sweet blood

A sweet odor in period blood is probably due to the acidic environment and the presence of bacteria in the vagina.

discharge with body odor

A person may notice an odor similar to body odor during their menstrual period. This is due to the presence of apocrine sweat glands in the genital region. Apocrine sweat mixes with bacteria on the skin to produce body odor. The glands release this type of sweat during periods of stress or anxiety. It is different from sweat from exercise or high temperatures. 

fishy smelling menstrual flow

This odor is often related to an overgrowth of bacteria in the vagina, such as bacterial vaginosis or trichomoniasis, which is a sexually transmitted infection.

It is more pronounced during menstruation as the blood increases vaginal alkalinity and creates a good environment for the growth of microorganisms. 

A person with trichomoniasis might notice an unusual fishy odor from the vagina and a change in vaginal discharge. They may also notice itching, burning, or pain in the genital area.

Risk factors for bacterial vaginosis include new or multiple sexual partners and douching.

Bacterial vaginosis produces a fishy odor. Doctors diagnose bacterial vaginosis through a series of tests and often prescribe antibiotics for treatment.

Menstrual flow: how much is too much and how much is too little?

The blood itself is scandalous. And there always seems to be more than there is. 

The amount of blood and fluid lost is usually between 5 and 12 teaspoons per cycle. On average, during each cycle the woman loses 35-50ml of red or brown blood, sometimes with clots. 

The regularity and intensity of the cycles can be slightly variable. And they will be especially so during menarche (first period) or the first months of reproductive life, after a pregnancy or during the climacteric (pre-menopause) or the last months of a woman's reproductive life. 

It is easy for ovulation to not be complete at this time and this can cause alterations in the regularity and intensity of the menstrual flow, both due to excess and shortage.

Likewise, other pathologies that hinder correct ovulation can have the same effect. This is the case of polycystic ovary syndrome. Uterine polyps (abnormal growth inside the uterus), fibroids (abnormal growth of muscle tissue in the uterus), endometriosis (endometrial tissue outside the endometrium, sensitive to the hormonal cycle) or adenomyosis (when endometrial tissue invades the muscular wall of the uterus) will also alter the volume of bleeding and should have a medical or specialist follow-up. 

On the other hand, some infections, such as chlamydia and gonorrhea, can cause bleeding between periods. If you notice blood before your period starts, consider contacting your doctor.

If these alterations occur punctually, you do not have to worry, but if it is something habitual, it is good that you follow up with a specialist, especially if you intend to get pregnant, to maximize your chances. 

Menorrhagia

A period of more than 80 ml of blood or the need to change pads every hour due to excessively heavy bleeding. It is known as menorrhagia. 

The excess flow can be related to the situations described above and to a poor elimination of estrogen in the body. It does not have to be serious, but it can cause a significant loss of iron in women and should be monitored with an analysis so that this does not happen. Low iron symptoms would be fatigue, weakness, or difficulty sleeping.

Hypomenorrhea 

This is the name given to periods with little menstrual flow. 

Its causes have to do with the lack of sexual hormones, with a low ovarian response or with altered ovulation. 

Clots 

The exact cause of blood clots during menstruation is not clear. The presence of small clots is considered normal, especially on the first and second day of the period, the most intense days of the period, but it can vary from one cycle to another 

When the uterine lining sheds, the body produces anticoagulant compounds that help break it down into a liquid, easily removable form. But if the endometrium sheds too quickly and too intensely at the same time, these compounds don't have enough time to work, and dark, purple-red blood clots will appear during menstruation. 

Clots do not imply any pathology but their size will determine if it is something physiological or not so much. If they are larger than about 2.5 cm, it would be interesting to seek specialist supervision. 

Medication influence:

Many people experience irregular bleeding, reduced bleeding, shorter cycles, or amenorrhea (no menstrual period) with progesterone-only pills, especially when the pill is not taken at the same time every day.

In turn, the Hormonal IUD, not the copper one, it is common for it to generate irregular or light bleeding. Some people even stop having periods.

In any case, if you identify yourself with any of the situations that we have described as less physiological, do not hesitate to carry out gynecological check-ups more regularly. 

Also, keep in mind that the nutrition and lifestyle will also have a direct impact on the quality and quantity of your periods and your general menstrual health.

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