Know Your Flow: What Your Period Says About Your Hormones

know-your-flowSymptoms experienced at different points of the cycle can tell us A LOT about our hormones and hormonal balance (or imbalance). The bleeding days of our period alone are packed with clues about our health, and one indicator alone is really all we need to look at: our menstrual blood.

As a women’s hormonal health coach, I talk about periods all day every day, but for those of you who aren’t quite with me yet, let’s just take a minute to get comfortable. Periods are pretty awesome, and the fact that as menstruators, we get a monthly report card on our health means that, if we know what to look for, we can make huge changes for our health and our lives. Honestly, I didn’t know how good I could feel – nearly all of the time – until I started really paying attention to my body, and to my cycle in particular.

So let’s talk about those periods, shall we?

Bright red with a steady flow


Click to enlarge

Click to enlarge

In a healthy cycle, estrogen builds up the uterine lining in the first half of the cycle, leading up to ovulation, and then progesterone holds the lining in place until your period comes.

A healthy period is bright red from start to finish and ideally lasts from 4-5 days. The consistency of the blood should be thicker than water, but with a smooth texture.

Bleeding ideally starts in the morning of the first day and can either start off heavy (meaning you need to change a tampon every 4 hours), and then gradually taper off, OR it can start with a lighter day before becoming heavy (every 4 hours), going to medium (every 5-6 hours), and then tapering off.

Dark coloring and a heavy flow

Dark red, purple, or even black bleeding that is thick in texture indicates a cycle with too much estrogen.

You may also notice multiple clots or a lumpy consistency. Bleeding flow tends is heavy, and you may need to change a tampon every 3-4 hours, or more often, for most or all of your period.

Women with excess estrogen may also experience breast tenderness, emotional PMS, fibroids and endometriosis.

Things that contribute to too much estrogen are processed foods, excess weight, over-consumption of alcohol, a stressed liver, endocrine disruptors like BPA and phthalates, and estrogenic foods like soy.

Light pink and light flow

On the flip side of the coin, a very light period that is watery and pink-ish in color indicates too little estrogen. You may experience a normal flow day or two followed or preceded by a few days of very light pink bleeding, and will be able to go more than 6 hours without changing a tampon for entire length of cycle.

Women with too little estrogen may also experience additional symptoms like vaginal dryness, dry skin, joint pain and low sex drive. Periods may become completely irregular and sporadic

Women with very little body fat have a greater risk of low estrogen. Other potential causes are low-fat diets, disordered eating, over-exercising, the birth control pill and stress.

Brown with spotting

Brown, rust-colored spotting before or after your period is an indication of too little progesterone. This symptom can occur in combination with too little or too much estrogen as well. In addition to brown spotting, women most commonly also experience a heavier than average flow.

Women with too little progesterone will also be prone to anxiety, particularly in the second half of their cycles, PMS, cyclical breast tenderness and difficulty becoming or staying pregnant.

The biggest culprit behind low progesterone is stress and high cortisol levels. A poorly functioning thyroid can also contribute to low progesterone. The birth control pill and irregular ovulation can also lead to low progesterone levels.

Getting back to bright red

If your bleeding is not following a healthy pattern, there are several simple things that you can start doing to help course correct.

For dark red, purple or black bleeding with a heavy flow, the first place to start is with your liver. If your liver is having a difficult time detoxifying excess estrogen from your system it will result in estrogen dominance. You can support your liver by reducing your alcohol, caffeine and NSAID consumption and increasing the amount of leafy and bitter greens in your diet. You should also reduce or eliminate estrogenic foods like soy to lighten the estrogen burden.

For light pink bleeding and a light flow, you want to make sure that you are eating enough healthy fats (coconut oil, fatty fish like wild caught salmon, and nuts), and getting enough protein. Animal proteins can be especially helpful here (so long as their grass fed, hormone- and antibiotic-free!). If you have an intense exercise routine, you may want to try easier workouts like yoga and walking to see how this affects your period.

For brown spotting and low progesterone, the first place to look is at your stress levels. If you have a lot of stress or anxiety in your life, how can you institute self care practices to help reduce the affect on your body? Easy workouts, walking, meditation, mindful breathing, giving up multi-tasking, making room for quiet time are all good places to start. Increasing your consumption of leafy greens is also important as these food megastars contain all the vitamins you need to support progesterone production. Try to get some green in at every meal.

Remember to be patient with your body – it may take a full two to three cycles to see a marked difference in your period. And now that you know how to interpret your bleeding, you can start to course correct whenever you see changes from your typical healthy flow.

Kara DeDonato is a fertility health expert who works with women to troubleshoot their monthly cycles and digestion so that they can feel their best and be their best selves. Read her full bio here

See more articles by Kara DeDonato


  1. This is fascinating – it would also be useful if you could indicate where peri-menopausal changes, change your blood flow…

    • Would love to know that as well

    • Thank you. I wish I had known this years ago! I had a hysterectomy due to fibroids with torrential bleeding, 10 years ago when I was 48. I had no idea the blood should be red! Mine was dark with huge clots. I didn’t know about the role of oestrogen. This info will help other ladies. Well done!

  2. Great info !! Do you have any thoughts about hormonal headaches and how to avoid them- Both at ovulation and at the start of cycle day 1? Thank you!!

    • Hi Beth, thanks for reading 🙂
      Hormonal headaches can be caused by different things, so I’d need to know more to give advice tailored to your specific case, but a good place to start is making sure you’re keeping hydrated during the points in your cycle that you usually experience headaches. Eating your water (think fruits like watermelon and cucumber) can be especially helpful. A magnesium supplement before bedtime might also do the trick!

  3. Thanks, Melanie! There’s just not enough info and open discussion about peri-menopause and menopause and we will definitely be covering those topics more. Stay tuned!

    • If you know of anyone doing a perimenopause study, I’d like to participate. We need more info on this confusing time in our reproductive cycle.

    • Great comment Melanie, I was thinking the same thing.
      Cycledork – Nice to hear that you’ll be covering the topics more in the future. 🙂

  4. Hi
    I haven’t been on my periods for almost 5months now,before that it happened that I went on my periods for more than 3 weeks and by reading this I went through all those colours with that period,went to the clinic said they couldn’t do anything for my,but now I dnt know what to do,or where to go for asvice,is it normal?mean I am only 23 years of age.

    • Hi Crystke, Sounds like a frustrating situation and this is most definitely not normal. Unfortunately clinics and medical practitioners often don’t have the time to address complex issues like this (which usually require dietary and lifestyle change, and often targeted supplementation) and will resort to prescribing the pill instead of treating the real cause or causes of the problem. I offer a free 15 minute consultation (absolutely free of charge) because I want everyone to get the info they need to start taking charge of their health. You can email me at to learn more about that. And also, check back here at for more info because we’ll be doing more pieces on how to treat specific issues.

      • I havent had my cycle n almost two months . I am constantly throwing up everything I eat and strong smells from cooking and etc makes me nauseous. My tubes.were cut and tied in July 2000 . Not sure whats going on with my body but I need help . Any ideas

        • Hi Nicole,
          Given the severity of the symptoms you’ve described (the vomiting + nausea) you should schedule an appointment with your doctor.

  5. Do you have any thoughts about a 22yo woman who menstruates once per year ( on average). PCOS has been diagnosed but is not being treated.
    I’d really appreciate any help.

    • Hi Elizabeth, there are actually multiple different types of PCOS, but most of them either start with or are exacerbated by blood sugar dysregulation. There are a lot of resources out there for PCOS. Try looking into or Both of those ladies have a lot of information on their sites. Lara Briden’s book, The Period Repair Manual, is another great resource. If you’re looking for more 1:1 support, I offer 1-hour sessions and coaching packages (

  6. Hi, thanks for this article. Is there any way you could address irregular periods with light flow (mostly brownish)? Could this be due to excessive exercise, or is the likelier scenario a hormone imbalance?

    • Hi Anna, I’d need more information to say definitively but this could potentially stem from overexercise. If you feel that you exercise a lot, you may want to cut back considerably. I advise clients with light or no periods to give up exercise entirely for what I call “movement practices” like yoga and/or walking. If you feel that not exercising will actually stress you out, then just try to be as gently as possible with yourself. You should never feeling like your pushing through your workout, particularly right before or during your period. I would need to know more information to be sure, but it is quite possible that you could be dealing with both low progesterone and low estrogen.

  7. Is it possible to get in touch with the author? I have further questions on the subject that my Dr has been unable to assist with.

  8. This is really interesting! How does it apply for those of us with PCOS? I have, at some point or another, experienced all of those. And as I’ve been losing weight (20kg in the last year all up) my period is getting lighter, yet I still experience clotting and occasional rust spotting

    • PCOS presents itself in different ways, but with all types the issue is that ovulation either does not occur or does not occur regularly – this is because the egg is not released from the ovary but instead forms a cyst. Without ovulation, progesterone production is drastically compromised. In order to regulate the progesterone, you need to create regular ovulation – which in PCOS cases can be inhibited by a number of different factors. Best place to start is by combining most of the advice: eat your leafy greens, manage stress as much as possible, get enough sleep, eat enough healthy fats and protein, and avoid exo-estrogens like soy. Feel free to email me at or check back here for a post on PCOS in the coming months!

  9. What about a cycle that’s often very light, mostly brown spotting, and then one day of light flow but bright red? You only have one option here for a light cycle and associate all other symptoms of colour and texture with heaviness.

    • Hi Jennifer, thanks for your Q. This chart and post have been simplified to include the major period types that indicate issues, but most of us women do experience much more variability than this. I would need to know a bit more about your specific case, but this sounds like it could be another presentation of low progesterone, or a combination of low progesterone and low estrogen.

  10. What about dark brown at the beginning of the period (day 1) that shifts to healthy red and ends with dark brown (day 5)? I’m assuming the same applies (it’s my liver?)

    • Strengthening liver health will always help your flow. However this sounds like you probably have sufficient estrogen and potentially low progesterone. Other reasons for stagnated (brown) blood flow could be poor circulation or a tipped (tilted) uterus. There’s a great ebook floating around out there called Align Thy Uteri ( that can help you determine if you’re dealing with a tipped uterus, and she also include instructions for self-abdominal massage that can help with all stagnant flow issues. You can also try a vaginal steaming ( if you’re up for trying something new!

  11. thank you, very informative

  12. This is fabulous thank you. I now know I have too much estrogen and not enough progesterone. Thank you.

  13. I agree about the peri-menopause. I always had regular, easy periods. Now that I am 45, they are getting wacky. The colour described for estrogen dominance definitely fits (I actually realised estrogen dominance was an issue a little while ago, and am trying wild yam cream to balance it out.)

    • Peri-menopausal women often do experience estrogen dominance as their progesterone levels start to drop. Focusing on liver health is a good place to start and you can also check out Dr. Sara Gottfried’s book The Hormone Cure – it’s written mostly with perimenopause in mind.

  14. Really interested in this article. How about a cycle that starts heavy stops for 12-24 on about day 3 the starts again? I have mild PCOS and my cycles have always behaved like this. I’d be interested to know if there’s a reason why 🙂

    • Hi Bex, would love more information on the rest of your cycle, but going on this PCOS could definitely be instigating it – sometimes cycles in which ovulation does not occur can have strange bleeding patterns. For instance, it could be that you had enough estrogen to approach ovulation and build up the lining, but not ovulate, then at a certain point hormones began to drop causing a withdrawal bleed, then you started to produce enough estrogen on Day 3 to stop the bleeding, only to have hormone levels drop again soon after. A bleeding pattern like this can often indicate that ovulation is not occurring. If that’s not the case, then it could also indicate a tipped uterus.

      • My cycles have always been like that, I’m in my 30s now with children. Absolutely no issues with fertility but have some other symptoms of pcos. Thanks for the reply 🙂

        • My period always stops on day 3 or 4 for almost a whole day. I start out with brown then it’s like the next day is very heavy bleeding, not to mention I get very nauseous the week of my cycle leading up to ovulation. I don’t have any other issues just always wondered why it’s brown in the beginning and the end and stops in the middle. I have very bad anxiety durning my period as well as depression at times. Trying to figure out what I need to do. I was on a progesterone cream it seemed to feed estrogen quite often because my breasts would be very sore!

  15. This is not correct information.

  16. Where are your sources? Do you have any primary source material to back up these claims? Why are you not citing any source material?

    • Hi Holly, thank you for your concern for making sure this is credible information – it’s definitely important. This article is based on information obtained through a year of research and practice as a women’s fertility coach and two years of training before that (one of which was with hormone specialist Nicole Jardim who studied under Dr. Sara Gottfried whom I have reference frequently in replies to comments). Resources would have been too numerous to list but include books like Dr. Sara Gottfried’s The Hormone Cure, Alisa Vitti’s Woman Code and Dr. Lara Briden’s Period Repair Manual, articles by mentors and respected women in the field (Melissa Ramos, Nicole Jardim, Alisa Vitti, Natalie Kringoudis), and articles in peer-reviewed medical journals such as the Journal of Reproductive Medicine and the Journal of Clinical Endocrinology and Medicine. Unfortunately most medical journals focus on studies involving the development of new drugs and surgical therapies, which are not healing modalities I promote as first-stop solutions, though they certainly have their place. All of that said, it should be noted that this article is reductive for the sake of length and digestibility and not all women observe these symptoms as indications of the hormonal imbalances discussed herein.

  17. My cycles were fairly normal and healthy until I hit my early 40s. Now it seems that high estrogen and low progesterone are the norm for me. Would also really love to hear more about the effects of perimenopause.

  18. I stopped with the 2months family planning in June 2016 and I have irregular periods.

    • Hi Shaheema, you mean you stopped a birth control method (other than Natural Family Planning or other Fertility Awareness Method)? It can definitely take some time for normal hormonal activity to return after stopping most types of hormonal birth control.

  19. Fascinating article! I have never seen anything like this! I have been off BCP for over a year now and use FAM for natural birth control. I’d like your view on what mine mean: I have a light flow day, then it drops to brown/rust spotting for a day, then it comes heavy and very dark red for about two days, then light and dark red for another 2 days. Does that mean I have low progesterone AND high estrogen? The thickness seems to be normal, at least.

    • Hi CC, high estrogen and low progesterone could definitely be possible. Since you’re tracking your cycles I’d be able to tell a lot more if you felt like sharing your charts with me! ( Other causes of disrupted bleeding patterns can be poor circulation in the pelvic or a tipped uterus.

  20. This is great info!
    My 14 year old daughter had her period for a year. When she went on a paleo based high raw content diet she lost 10 kg. Her period also stopped! She is almost 15 now. Do you have any suggestions?

    • Hi Sofis, period regularity can be a very sensitive thing for the first year or so of a woman’s menses, so the dietary change and weight drop could definitely have caused her cycle to stop. I’m afraid I would need more information to feel comfortable making concrete suggestions – but a safe place to start would be to encourage her to incorporate more carbohydrates into her diet. If she’s doing raw paleo, she’s probably doing Ok on fat and protein intake. She’ll probably be resistant since she’s seen some weight loss on her regimen, but perhaps she’ll be open to at least incorporating a sweet potato (at least its paleo!) a few days a week, from there you could try millet (a health GF grain) or quinoa.

  21. Thank you for the great article! I’m looking to go on a birth control method that doesn’t mess with my levels too much. I was on the implant (progesterone only) and it gave me really light pink periods. I missed the natural flow. Any advice on birth control?

    • Hi Sophia, I love that you’re prioritizing your period! I’m a big proponent of the symptothermal method of Fertility Awareness, but it does mean really getting to know your cycle and monitoring your fertility every day. And you want to make sure you’re learn it from a good practitioner. The book Taking Charge of Your Fertility is a great resource, and Hannah Ransom ( has a wonderful e-course. If you want something more low maintenance, there’s the copper IUD – it doesn’t interfere with the brain to ovary communication, but it can cause zinc deficiency. In my book, all birth control methods have their drawbacks, its just about figuring out what you’re willing to compromise on and what you’re not.

  22. Thank you for this info, and so glad to have found help here! Coming from a woman who has atypical PCOS symptoms and periods that are all over the map. You’re a huge help!

  23. Very informative article, I was wondering about my own cycle as well, for the last 21 years my flow has been very very heavy, almost debilitating.. having to change a super plus tampon every 2 hours for at least 3 days… my Dr told me it was because of my weight gain after having my last child.. recently my flow has been what seems to be “normal”, it’s nice but at the same time worrisome….

    • I’d need a full health history to make concrete suggestions, but a heavy flow can be the result of weight gain. Body fat contributes to high estrogen. If your flow has leveled out then I wouldn’t worry about it – keep doing what you’re doing! If you see a heavy flow creep back up, try to make some of the changes suggested here and see if it helps.

  24. It is like I’ve seen all of these colors at different times. I do suffer from endometriosis; but it seems like everything else you are talking about i suffer from as well. ..

    When you say green leafy bitter veges; which ones exactly do you mean? Also; could any of this be indicative of early menopause?I started noticing that my period became fleshy pink all of a sudden n i started to freak out

    • No need to freak out! I would need more information to make suggestions, and you can schedule a free 15-minute consult with me by emailing me at

      Endometriosis can often be helped by controlling inflammation in the body, and by focusing on gut health. Eating bitter leafy greens and vegetables is also always helpful! Bitter greens include arugula, Brussels sprouts and herbs like parsley and cilantro. Greens like kale, bok choy, and even spinach are also nutrient-packed!

  25. Thank you very much for this valuable information Kara!

    I am 40 years old, during my period the bleeding flow is heavy with multiple clots and a lumpy consistency. I’ve discovered one fibroid in my uterus.
    Could you please give me more advice to reduce the estrogen… what tests I should do in my case especially for the Liver work?

    • Hi Nona, if you haven’t already had your doctor check out the fibroid on your uterus, you should get their opinion just to make sure there’s nothing else going on there. Many women do start to see their flow get more heavier and/or more clots as they approach perimenopause. With reducing the estrogen load its not so much about getting tests done on your liver, but just reducing the amount of toxins it has to work through (including alcohol and caffeine) and boosting it with the right nutrients. Broccoli and cauliflower contain compounds that are really great for detoxing excess estrogen to start with. Dr. Sara Gottfried’s book The Hormone Cure is a great place to start.

  26. Hello, what a fantastic article, so helpful and informative.
    I’m in my early 40’s and mindful menopause in nearing in the coming years/perhaps decade and wonder…does the flow colour change as you age?
    If you are a balanced healthy woman right up until the “change of life” presumably the bright red colour would remain up until your last period?
    Love to hear your thoughts.
    Michelle x

    • Hi Michelle! Great Q. For women in optimal health there should be minimal discomfort heading into perimenopause and menopause, although the cycle will change and of course eventually your period will disappear. One thing many women notice is there cycle getting slightly longer. Many women experience a heavier flow, while some experience more spotting. Dr. Sara Gottfried’s book The Hormone Cure is a great resource for learning more about what you can do for the smoothest ride possible!

  27. Hi, I got my periods four days back, it’s not spotty or anything but I just had a problem with ovarian cyst and consistent bleeding that only stopped with pills, the cyst has dissolved but I am worried that the periods will not stop on their own but I have no time to visit my gynec :^

    • Hi Ani, I’m afraid I don’t know enough about your situation to be able to offer advice. Regardless, if you’re dealing with heavy bleeding due to a ruptured ovarian cyst you should definitely make time to see your doctor.

  28. great chart! Curious about your opinion of this experience. I use a diva cup and I’ve noticed on the first day of my cycle my blood separated in the diva cup. So the bottom half will be a darker red and the top will be watery translucent. I’ve been told this is normal but just looking for more insight

    • Hi Mona! I’ve heard lots of people say this happens because the red blood cells separate from the plasma (which is white or clear) in the cup. This seems plausible to me, but I haven’t heard a conclusive response yet from a source I deem completely credible. Sorry that I don’t know more!

  29. Hello Kara, do you have any information about menopause? I recently had a hysterectomy,they took everything but my cervix. I’m ALWAYS hot and my sex drive went from a couple times a day, 4 days a week to please don’t touch me, I’m not interested. Can you help or point me in the right direction.

    • Hi Marie, unfortunately this is not my area of expertise. I wish I could help. Best resource I know of for menopausal women is Dr. Sara Gottfried – you may find more info on her site.

  30. What about red spotting for 3-4 days before a period? I have Hashi’s that is being treated, but I can’t help but feel things are still out of whack.

  31. Hi there! I have a healthy red flow that lasts approximately 5-7 days. Since switching to a menstrual cup, I have been able to actually measure my flow. it is approximately 120-150 ml. This is MUCH heavier than what I have read is normal. I have no other serious symptoms except for being EXTREMELY tired during the first few days when I am heaviest… any thoughts?

    • Hi Tiffany, I love that you’re monitoring all of this! Unfortunately I can’t verify if this is really heavy or not without knowing the time duration in which this amount of blood pools in the cup. Generally speaking though, if you have no other symptoms, you shouldn’t worry about it. As far as the fatigue, it is normal to experience a dip of energy right before and leading into the first few days of your period because this is when all of your hormone levels will be low. Try being very mindful about scheduling extra rest or downtime, or try to get an extra hour of sleep during the nights right before your period and the first few nights during it. If this doesn’t help, then you may want to get your iron levels checked.

  32. Hi there. I have been diagnosed for pcos 8 years before, at that time my periods was very irregular like once in 6 months and than duration was more longer like once in a year.i went to fertility clinic coz i wanted to get preg i got pregnant after 1 year of fertility treatment. He was my 2nd baby , after he was 1 my periods got regular all of the sudden and i got preg with out any fertility med.after my 3rd baby periods got normal after almost a year when he was 2 i got preg 4th time(i had gestational diabeties in all 4 preg) so yeah after my 4th baby my period was like brown dot dot for 8 month and after 8 month its like they r super flowyyyy i dont know what is going on but they r pretty regular like 30 days cycle but they r very heavy like u mention every 3/4 hour need to change pad , and when i go for pee i feel their is too much slimmy thing coming out is that can be TOO MUCH ESTROGEN problem or PCOS plz help me to find my doc is aweful i dont wanna see her

    • Hi Aisha, this does sound like it could be too much estrogen. I can’t make suggestions with confidence without a full health history but I would suggest following the guidelines in the article for high estrogen – these are holistic simple fixes with no downside so it can’t hurt to try them. You should also be monitoring your blood sugar levels – if you consistently dealt with gestational diabetes you could be dealing with pre-diabetes all of the time. Try to limit your exposure to sugar and processed foods, and to eat balanced meals containing a good carbohydrate source, protein and healthy fat.

  33. Thanks for this information! I have often asked my gynecologists about the heavy flow and clots – sometimes like pieces of liver (sorry to be gross), and then the black “junk” at the end of my period. They never have any answers about how to help myself except to tell me that my uterus, cervix, and ovaries are very healthy though I do have a bit of endometriosis on my left ovary. I positively LOVE leafy greens and crave them! It’s nice to know that there are some helpful interventions I can take on my own behalf without having to take pills!

    • Hi Christy, ugh, this just kills me – healthy ovaries do not have endometriosis! I’m sure your doctors just don’t want to worry you about something that is not absolutely detrimental to your health. That said, you definitely do not need to live with the symptoms you are already experiencing and things could potentially get worse – which may or may not be likely depending on how old you are and other factors. The heavy flow and clots could definitely be related to the bit of endometriosis you are experiencing, and there are definitely holistic fixes. Getting leafy greens in at almost every meal is a great place to start. Endo is also best managed by managing inflammation and improving gut health. It might be worth looking into if you have any food sensitivities or intolerances, and anti-inflammatory protocols may help as well. If you’d like more info, feel free to get in touch with me at Good luck!

  34. Very interesting article. I have 2 teen girls that have had their periods for 4-5 years. Both struggle with issues.

    The oldest has a very heavy flow for a 6-8 hour stretch that she soaks right through pads in an hour or two. Lots of cramping too…then some months the periods lingers with brown spotting for a week or more.

    The other daughter has normal regular periods but once finished she has 2 days of extreme tiredness, low energy and low strength.

    Wondering your thoughts on that

    • Hi Annette, I love that you’re looking out for your girls in this way! I’d need more information to give suggestions, but from what you’ve said here, I would advise that for the first girl you increase leafy green intake, and work with her to put together meals that keep her blood sugar balanced (a good protein source, whole food carb and healthy fat). You may also want to look into seeing if she has any food sensitivities. You don’t necessarily need to go the ALCAT testing route, but you could do a modified elimination diet, or just see if she’s having regular good bowel movements, and if her digestion is affected at all by gluten or dairy (the two main culprits). For the second, I would suggest having her be mindful of not pushing herself in the days before or during her period: getting an extra hour of sleep, having a bit of downtime, etc. You may also want to get her iron levels tested. Many young women are at least borderline anemic.

  35. My period is usually medium the first day and moves into heavy the next two days and then medium for two days and then light. Almost seems like it stops a day and then it’s medium for a day. And then I spot for a few days after. Usually i pass a lot of clots and have breast tenderness shortley before and during. I’ve been off birth control for 2 years now and had no success getting pregnant. I’ve always had heavy periods and painful cramping. I had a internal imaging done to check for polyps and possible endometriosis but came back negative. Based off ur chart it seems like I need more greens in my diet. Any other tips to help with my symptoms

    • Hi Amber, leafy greens help with everything, so definitely a good place to start! More information on your cycle (like length, presence or absence of cervical fluid) would enable me to better help you. Excess estrogen sounds like it could definitely be at play, and liver support would be helpful (even a cup of warm water with lemon in the mornings). If you’d like to take a deeper dive into your case specifically, please get in touch with me at if you’d be interested in a free 15 minute consult. Helping women who struggle with fertility post birth control is a super specialty of mine!

  36. How about a period that is every two weeks and very heavy, dark, and clotted and last about 5 days. Then I think it’s over and I’ll spot a few more days…. Cramps and discomfort during period and then discomfort in my lower belly most all the time. Left ovary hurts most always and I’m unable to workout like I use to, due to pain. I do yoga now with almost no pain and love it. I’m told no cyst on ovaries, no endometriosis, but a prolapsed uterus. I’m 35, one child by caesarean, and always exhausted since this started over a year ago. I’m a healthy weight, active, but now I can’t keep up like I used to and am emotional, and anxious lots! Hysterectomy is what I’m told I need? Insurance wants me to do two other surgeries first

    • Hi Kristi, wow! This does sound like a frustrating place to be. Unfortunately your case is beyond my skill level, but I do know that there are certainly more holistic routes you can try before surgery. I’d recommend looking into working with Jessica Drummond, founder of the Integrative Women’s Health Institute. My mentor Nicole Jardim is another option but she doesn’t do as much 1:1 work anymore. Email me at if you’d like other suggestions!

  37. I have a question. My cycle starts with light bleeding… mostly spotting. The next day will be bright red and heavier for 2-3 days and then it tapers of a little and comes back the following day a little heavier. I will end usually with darker blood-that is thicker. My cycles seem to be normal and always follow this pattern. I stopped nursing in April if this year and noticed I cramp a little more since the. I also only have one ovary and can tell when I ovulate… it can be uncomfortable. I’ve had trans vaginal ultrasounds that’s show nothing abnormal.

    • Hi Gabrielle, if your pattern is consistent and you have no other troublesome symptoms, then its most likely just your unique cycle pattern and perfectly fine. Its not very common, but some women can tell when they ovulate. If you notice and sudden changes, or drastic changes over time (like the cramping continuing to increase), that’s when you should look into things further. For now, you may look into a magnesium supplement to help with the cramping (check with your doctor first!).

    • Hi Gabrielle, if this pattern is consistent for you then it is likely your unique pattern and not an issue at all so long as you are not experiencing other symptoms. The most important thing with the symptoms noted in this article is to flag them if your cycle changes to include them. With regard to your increased cramping, you might look into Evening Primrose Oil or magnesium supplementation. Please do your due diligence and check with your doctor first!

  38. This is helpful, I would love a more detailed article! What about a cycle that is 25 days total, 5 of them bleeding. Always one day of cramps, sometimes so bad I can’t move, other times I am fine with enough pain meds. Usually 1-2 heavier days with bright red and a few dark clumps then 2-3 very light days with some dark red/ spotting? I’ve been off the pill for over two years and tracking my period.

    • Hi Sam! I would need more information to make suggestions. That said, if you have a luteal phase (time between ovulation and your period) of at least 9-10 days then a cycle of 25 days with 5 bleeding days is good! Given your clumps, you might try following the suggestions for the high estrogen (though that may not definitively be the case). Evening primrose oil and magnesium are good supplements for cramps, but please check with your doctor before taking new supplements.

  39. I am wondering how the copper IUD (non hormonal) can influence this? Since going on copper IUD I have thicker, darker periods but I thought that was a common side effect of IUD just giving you heavier periods. Is that true, or should I be concerned about my hormones? Does that mean copper IUD doesn’t promote health?

    • Hi Gina, most methods (perhaps all!) of birth control have their drawbacks. The copper IUD is a low maintenance method that I often suggest if people are not interested in fertility awareness, but it can cause a mineral imbalance and it often irritates the uterus, leading to inflammation and causing some of the symptoms you’ve described. In my book, this doesn’t necessarily detract from your health, but it doesn’t promote it. Of note, these symptoms may subside as your body adjusts. If you’d like more information, feel free to email me at

  40. Hello Kara, thanks for this article. What additional advice can you give for my situation? 33 years old, on the pill for 6 years then stopped for this past 3 and trying to conceive. Before the pill, I had infrequent menses, and after the pill too. I’ve been tracking my data on an app called Ovia. I do get positive ovulation tests, and I have a 42 day cycle length, but I often skip 3 or more periods completely. No PCOS, confirmed with my obgyn. Thyroid normal, HSG test normal. Low progesterone?

    • Hi Kimberly, this is really my specialty and if you’d like to schedule a free 15 minute consult, email me at Whatever issues you had before hormonal birth control persisted (while the symptoms may have been masked) of worsened while you were on it. It’s great that you’re tracking your cycle – that can give you so much information. You may not necessarily have low progesterone. Depending on other observations it may be low estrogen, delayed communication between your hypothalamus, pituitary and ovaries. In my experience both personally and with clients, diet and targeted supplementation can turn things around fairly quickly!

  41. So what about bright red blood flow and blood clots?

    • Depends on how many clots you’re seeing. Some are definitely normal! Also, if you have no other symptoms and your observations cycle to cycle are consistent, then there is no reason to worry at all! The goal is to observe your unique pattern, and then if you see any shifts to use this guide to determine what may be going wrong.

  42. So after reading this and the comments I’m curious. I have had 3 kids and my cycle seems to have gotten tougher after each one. I now have intense PMS the week before, breast tenderness like when I was pregnant, irritability, etc. I have always had a 30ish day cycle with heavy bleeding and lots of clots in the first 2 days. NO bleeding on the 3rd day and then normal red flow the last two days. I also always get a migraine the week before bleeding starts and the last 24 hours (sometimes longer) of bleeding. The biggest change since pregnancy (and nursing) has been the PMS symptoms. Could this all be low estrogen related?

    • Hi Karie, I would need to do a full consult to be confident but this is actually typical of estrogen dominance. This just means that your estrogen to progesterone ratio is off and favoring estrogen. You could possibly have low estrogen and low progesterone (with more estrogen relative to progesterone), or too much estrogen relative to normal progesterone, or normal estrogen combined with too little progesterone. If you have further questions please email me at

  43. Hi! Great article.
    I was diagnosed with low progesterone and we are trying to conceive. So you recommend eliminating gluten and dairy? I heard this helps increase the levels? What else can I do? I’ve tried bovine ovary pills, less work hours, acupuncture, organic and healthy diet, b supplements and now maca…thank you!

    • Thanks, Jessica! Vitamin C is actually the only supplement clinically proven to improve progesterone levels. That said, all antioxidants – including Vit C – carry a toxicity risk so please consult with your doctor before taking. Other supplements may help as well. Avoiding gluten and dairy is not necessary unless you feel you are sensitive or intolerant. I can give you more information on determining that if up email me ( Managing stress is crucial for boosting progesterone due to something called pregnenalone steal. Acupuncture can help – just be patient with your body and remember these things take time!

  44. One of the most frustrating questions that I keep being asked about my periods is do I experience clotting. I have 100% no idea what that would look like, I have basic awareness of anatomy and biology so I know what a blood clot is, and can tell when I have surface level injuries when they’re starting to clot, but WTF does a period blood clot look like?!

    I’m pretty sure now after reading this article that yes I probably do experience blood clots during every single period, but it’s a question that I’ve been unable to understand/answer for about 4 years now. 4 years I might ad of infertility and actively trying to seek information on what I’m supposed to do about things. Why couldn’t I have been told I need to eat more leafy green vegetables? That’s actually an easy simple achievable step to take. I had a feeling that I might have excess/out of balance hormones and have enquired about it the entire time, but it’s always been drs only looking in to one side of the equation. Thank you for this plain language article, I might be better armed and able to answer questions next time.

    • Hi B, blood clots are simply coagulated blood – someone’s they look liked of like red chili pepper flakes in the fluid (cringe – I hate using food analogies!) or they can be much larger and more obvious. I should note that some blood clots are normal and if you experience them with no or minimal other symptoms you shouldn’t worry. There are definitely holistic fixes when experiencing infertility. If you’d like greater clarity, please feel free to email me at

  45. Awesome info. I have always had level 10 pain cramps during my period and recently found out that I have slight hypothyroid (non-hashimotos) so i started taking some iodine supplimentents (the US daily value) and have seen a huge change – from dark dry blood to a lot of bright red, runny blood, but with huge fist size clots. Also the cramps are not as bad. Can you help explain whats going on and if im on the right track?

    • Hi Amanda, I’m so happy that you’re seeing results! Improvement of your symptoms alone means that you’re on the right track. The entire endocrine (hormone) system is interconnected so thyroid hormones play an important role in reproductive hormone health. It sounds like your underactive thyroid is being helped by iodine (which makes sense) and this is improving your cycle. To further your results you might look into vitamin D level testing with your doctor and supplement if necessary, as well as following an anti inflammatory diet when possible.

  46. Unfortunately I have been estrogen dominant for a very long time, and already live by the guidelines to help manage that. And for quite a long time. Sooooo… now what? I don’t know why else to do. I’m pregnant now, and hoping that after all these years menstruating (32 YEARS!) I would hope that it would have improved. This is my 4th baby, 3 daughters, 2 early losses, and this baby. Hoping things shift after baby. Hope, hope, hope!

    • Hi Jen, I would need to do a full health history and consult to provide you with information ( Many other factors could be at play if you’ve been following a high estrogen protocol without results.

  47. i really like the idea of learning about yourself/your body and knowing what different things mean, BUT i am concerned by the way this post labels these differences as not normal — as far as i know these are mostly ALL normal things to experience in a period. the woman who wrote this is not trained as a medical professional and while I don’t think the medical industrial complex is by any means an expert on our bodies, I question the overgeneralizing and oversimplification of this information.

    • Hi Liz, thank you for your most valid concern! This article is definitely simplified for length and digestibility, which certainly has its drawbacks. Most women will experience these symptoms at some point without major cause for concern and some will experience them as a normal part of their own unique cycle pattern. I can only say that I felt it was important to get this information to women who would benefit from it, and that I am a trained professional, even if I’m not a standardly trained medical professional. My goal is to empower women to seek the best magical treatment and explore all their options for health, not to supplant western medicine or the advice of their doctors entirely.

  48. Wow, I am stunned a gyn has never asked or mentioned this before, thanks! I’m curious, mine is basically healthy colored, maybe between bright and sometimes dark, but it only lasts 2-3 days my entire life. Any meaning there? I’m 40 and never been pregnant. Haven’t tried, but still hopeful.

    • Hi Melissa! 4-5 days of bleeding is statistically ideal for achieving pregnancy. This is mostly because it correlates with having a healthy, plush uterine lining for an embryo to implant in. That said, if your flow has pretty much always been 2-3 days with medium to heavy bleeding, and you have no other symptoms, then there’s no need to worry. And there are also supplements you can take and nutritional guidelines you can follow to increase blood flow. In order to achieve pregnancy you also might want to observe your cervical fluid to make sure you’re producing fertile quality fluid around the time of ovulation, and look to see if your luteal phase (the time between ovulation and the next period is at least 9-10 days long. All of this will tell you you’re cycle is in a good spot for conception! (Any questions feel free to email me!

  49. This is an area of my health that I often overlook so this article was eye-opening- thanks for writing it! The women on my mom’s side of the family, going back generations, have experienced truly unbearable periods. I was the first to be diagnosed with dysmenorrhea, but it’s pretty certain that most of the women in my family also suffer/ed from it. Because of the incredible amount of pain my periods cause me, I started taking the pill when I was 15 after talking with my doctor and gynecologist. My question is: does this article still apply to me, since I am on hormonal birth control?

  50. Hello Kara, thanks for this article!
    Can I do yoga during my period?

    • Hi Jennifer – yes, you can do yoga on your period! Some yoga teachers teach that you should avoid inversions (like headstands) on your bleeding days, which is something I personally practice.

  51. I typically have a bright red, moderate flow for 2 days, then maybe a day of a little bit darker flow, then another day or two of darker intermittent spotting. I’ve always thought it was just the last of the old blood making its way out after the true menstruation, but does this sound problematic? Or does it sound normal?

    • Hi Mary, you’re probably right that its older blood leaving the uterus – hence the color change. The bleeding pattern you’ve described isn’t something to worry about – particularly if it’s been consistent and you have no other symptoms. You might try some pelvic floor exercises or monthly vaginal steaming to see if it creates a more consistent, bright red flow without as much spotting towards the end – but like I said, no reason to worry from what you’ve described!

  52. This is helpful but I am still confused a bit. I have been complaing for years about the brown spotting before and after the full bleeding begins each month. For the past 5 months I start out brown spotting For 1/2 a day to a full day prior to the deep red huge clotting changing tampoons every hour for one and a half to a full two days and then half a day of the bright red and follow up with another week of the brown spotting. I do have a tilted uterus and have had all my hormones tested, Dr stated all were in normal range. I have cut out all soy internal and external produts since November 2016. I am going to order that hormone book you mentioned above and hope I can find some help.

    • Hi Sheila, thanks for posting – that does sound frustrating and something is definitely going on based on your symptoms. I’m sorry your doctor hasn’t come up with better answers! Normal ranges vary from lab to lab and are also different (much broader) from the optimal ranges functional medicine practitioners use (which is what I take into consideration when working with clients who have had bloodwork done). A lot of conventional doctors also don’t test for the full range of things they need in order to get the complete picture of what is going on – since your reproductive hormones are very closely tied to other hormone precursors, adrenal and thyroid function. Some hormone levels can also be “falsely normal” if they are being boosted by something another hormone is doing (or tested at the wrong time of the cycle) All of that said, removing soy is a good start since your symptoms primarily point to an excess of estrogen.

      If you’d like, I’d be happy to take a look at your bloodwork to see if anything jumps out, or if there are some missing pieces you may want to get tested as well. To do that, book a free 15 minute consult, fill out the health history form to the best of your ability – and you’ll have the chance to upload docs at the end. Link is here:

  53. Great article! By the looks of it I have estrogen dominance and low progesterone. I bleed slight brown first day then straight into two-3 days of very heavy, very clotty deep red blood changing a tampon every 1-2 hours. Then it tapers off to bright red for a couple more days then back to brown for a total cycle of 6-7 days (every 27 days). I have eliminated dairy and gluten over the past 6 months and have completely gotten rid of PMS and cramps but heavy bleeding still remain. I do all the things you say for that – no processed foods, leafy greens, broccoli and cauliflower everyday, no alcohol, no caffeine, and no soy and avoid BPA. I am at a loss and feed up with heavy bleeding.

  54. Great article and nice involvement by audience

    Great to see this


  55. For over a year now I have 2-3 days of bleeding mid cycle, and then my normal period as well. It’s super frustrating and doctors have checked everything and say my hormones and uterine wall are normal. Since this has started my periods have been very clotty, with very little red blood. The clotting was also an issue when having sex, no pain, but it would sometimes cause bleeding between the middle mini period and my try period. I’ve tried different birth control pills but no change. Any insights? I found your article interesting, I wish someone had shown me this when I was younger and starting my period.

    • Hi Shannon, thanks for your note! I also wish I learned all of this when I as younger 🙂 I would need more information to provide suggestions – I wouldn’t want to weigh in without having a more complete picture.

  56. Wow this is fascinating! I’ve had the problems with brown spotting after my period ever since having a procedure called LLETZ for removing abnormal cells from the cervix. I also had really bad side effects from the procedure, and am now connected with a dr in the states doing research and anatomy of the cervix. There’s been an idea proposed that the cervix may play a part in regulation of sex hormones. After the procedure my previously healthy sex drive completely disappeared.

    It’s interesting to think about the stress element, as my body has basically felt like it’s in fight of flight ever since the procedure. I’m definitely going to try out these suggestions, thank you!

  57. even i want to get in touch .. I used to suffer alot due to over bleeding &body acne during mensurations,.Can u please help me out .Every month i used to suffer for 10-12 days …And i want rid from these..

  58. Hello! I have just been looking at your webpage, and I was impressed with the information you provide. If you have a moment, I was wondering if you could advise me. I am 35, and have one daughter (2), and have since had two miscarriages- one at 11 weeks, and one at seven weeks. I was diagnosed with a pituitary tumor in 2012, when I stopped having my period. It was discovered that my prolactin level was at 221, when it should have been lower than 20 for a non-pregnant female. I was put on bromocriptine for a few months (until I developed Raynaud’s syndrome), and then switched to dostinex until becoming pregnant in 2015. I had no trouble conceiving my daughter. We tried for two months, and had success. When I found out I was pregnant, I stopped taking dostinex (per the advise of my endocrinologist) while pregnant, and then for the following year while breastfeeding. I wanted to conceive again, and so I stopped my mini pill immediately after the year of breast feeding, began dostinex, and we began trying. I could tell my hormones were off because my period was scant and irregular. I began taking an herbal supplement because I had taken it at the time my first daughter was conceived. It contained wild yam, saw palmetto, and fenugreek. I had taken this supplement to restore breast health. I had lost a lot of weight after being diagnosed in 2012, and my breasts were a bit on the saggy (for lack of a better term) side. I began taking this herbal supplement, and immediately noticed that it increased the moisture in my vagina (which had been on the dry side since I was 20), and sent my libido through the roof. Anyway, this supplement did seem to regulate my period (I didn’t know how or why it worked), and I was able to conceive again in October 2017. I stopped the supplement because I didn’t know if it was safe to take while pregnant. And I lost the baby at 11 weeks, naturally in my home. They didn’t check to see what the possible cause was. I saw only my obgyn, not my endocrinologist, and they said there really was not point in trying to figure it out because it was likely just a natural phenomenon. A few months later, we decided to try again. My periods were scant and irregular again. So, again, I began taking that supplement (wild yam, saw palmetto, and fenugreek). It normalized my cycle immediately, and we immediately conceived. I stopped the supplement, and we lost the baby at seven weeks. This time I went to see my endocrinologist, and had her test all my hormones. My progesterone was 3.1. They say it should be between 4.1-34 in the first trimester, and doctors often supplement with progesterone cream if it’s lower than 10. My estradiol was 27, and it says that it should be no lower than 188 in the first trimester. So, I’m assuming that I have a severe hormone imbalance. My prolactin is normal. Even now, I haven’t been on dostinex since July 25th, and it’s still at 14.8 (we’re watching to see if it starts to go up). But clearly my progesterone and estrogen are too low. And I have felt like they’ve been too low since I was 20. Could the pituitary tumor be causing not only my prolactin to be high, but my estrogen and progesterone to be low? Even when my prolactin normalizes, the other two hormones are generally low unless I take that supplement. Now, I’ve read that it’s likely the wild yam that is making the difference, and saw palmetto and fenugreek are probably two herbs that I should not be taking when trying to conceive. In you expert opinion, what can I do to increase my estrogen and progesterone? I exercise regularly, but am only running four miles 1-2 times per week right now. Other than that, I’m doing a little circuit training, a little weight training, but a lot of yoga and pilates. I’m about ten pounds overweight, but have a generally healthy diet. Should I see about being prescribed estrogen and progesterone supplements in order to increase fertility and maintain pregnancies? Should I supplement with wild yam to get pregnant, and then continue it throughout my pregnancy? If you made it to the end of this dissertation, thank you so much. Any and all thoughts and ideas would be sincerely appreciated. We are really hoping to have one more baby. I’m getting ready to turn 36, and I just feel like my hormones are an absolute mess. Thank you for your time.

  59. wow!! this is the first time I know how to looks my hormone from our own blood. This is really are a new knowledge. Thank you

  60. So what if your daughter starts her period at 13 then it gets irregular and then completely stops altogether by age 15 and is still not back by 19. Doctors say this is normal. I say there is something wrong. Healthy weight, nice and active normal teenage girl.

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