What Should Normal Menstruation Blood Look Like?

Menstruation blood, period blood or menstruum can be a sensitive medical issue with women.

Women have often asked me questions related to the characteristics of normal menstruation blood also called menstruum. Slight variations will hardly miss a woman's attention.

This page seeks to present a brief description of what normal period blood should be. But first, we will look at the origin of menstrual blood.

Origin Of Menstruation Blood

Menstrual blood originates from the normal shedding of the endometrium during normal menstruation as part of the ovulation cycle. Though it is called vaginal bleeding, remember that the blood does not originate from the vagina. It simply passes through the vaginal lumen. The term vaginal bleeding has been used medically to describe any bleeding from the female genital tract that comes out from the vagina.

Menstrual blood originates from the uterus and is squeezed through the cervix into the vagina.

Components Of Menstruation Blood

Menstrual blood is not composed of blood only. There are three qualitative components found in menstrual blood

Blood. Blood is the main component of what is collectively called menstruation blood or menstruum. As the endometrium breaks down, small blood vessels leading to the endometrium are exposed and blood oozes out. Normally these open vessels usually constrict and close. Blood is the major quantitative component of the menstruum.
Endometrium. As part of normal menstruation, the endometrium is shed from the uterus. The shed endometrium is mainly made of cells and their fibrous support. The shed endometrium is not blood! It is hard material that may be seen in the normal menstrual blood as tissue or clots. Some women have seen this tissue material during normal menstruation and report that they probably had a miscarriage. Others have seen them it and called them clots for they really just look like true blood clots. The amount of shed endometrium is less than the amount of blood in the menstruum.
The unfertilized egg. The third component in the menstruum is the unfertilized egg. It is indeed negligible with respect to its volume when compared to the blood or the shed endometrium. It is a single cell which cannot be seen with the naked eye! It is however worth noting that the egg is there as part of the flow.

Normal characteristics of Menstrual Blood

Volume of menstrual flow. The average volume of menstruum is about 35 ml with a normal range of 10 to 80 ml. You need not have a measuring container to know that you are within the normal range! Many women have learned from experience to determine the normal volume of menstruation blood by the amount of pads or similar menstrual product required to stay dry, and how soaked or wet these pads are.
The color of menstrual blood. There could be a wide range of normal menstruation blood color. Usually, it is bright or light red in color, looking like the bleeding from a cut finger especially at the onset of menstruation. It could also be brown or almost black towards the end of menses. The reason is simple to get. As blood stays out of the blood vessels, it begins to change its color. The black or brown color might just be normal menstrual blood that has changed its color as it passes through the cervix into the vagina. It is not usually black from the blood vessels they are coming from! Note however that persistently black menses from start to finish each month or similar feature should not just be labeled as normal. Talk to your doctor.
The consistency. It may have the normal viscosity as blood from a bleeding finger or it could be watery and thin. It may also be stringy.
Odor. Normal menstrual blood should not be offensive in odor. Offensive vaginal discharges may be a sign of genital infection. However, blood may accumulate in the vagina and stink if it is left there for a long time especially more than 6 to 8 hours. Good menstrual hygiene should salvage such situations.
Clots. Women have often wondered aloud to me if blood clots should be found in their menstruum. Normal menstrual blood usually does not clot because it contains chemical substances (anticoagulants) that prevent it from clotting. However, the shed endometrial tissue may appear in the liquid blood as hard material, looking like clots. These endometrial tissue clots are what most women sometimes see in the menstrual blood as clots. They are really not true blood clots formed by the coagulation of blood but are indeed “endometrial clots". However, true blood clots may occur especially during heavy bleeding when the amount anticoagulant is relatively small and insufficient and so some of the blood may begin to coagulate. Remember to seek medical attention if there is heavy bleeding or recurrent blood clots.