‍Menstrual Cycle

Your menstrual cycle is a vital indicator of your overall health. Understanding your typical cycle can help you confidently manage menstruation and take a proactive approach to your health and wellbeing.

What’s your “normal”?

Every menstruation cycle is unique, which is why it’s important to understand what is normal for you. Your menstrual cycle might be regular — about the same length every month — or somewhat irregular. Your period might be light or heavy, painful or pain-free, long or short, and still be considered typical.Within a broad range, "normal" is what's typical for you.

Below are some general patterns and ways to measure your typical cycle:

Cycle length:

• A “normal” cycle is 28 days, but typical menstrual cycles range from 21 to 35 days.
• TIP: Use a pen and paper or digital app to track your cycle over a few months to determine your average cycle length.

Bleeding duration:

• A “normal” bleed length is five days, but bleeding can last between 2 to 7 days.
• Often the flow will vary from light to heavy and may change day to day.

Flow volume:

• On average, you lose about 30 (6 teaspoons) to 80 millilitres (5 tablespoons) of blood during your period.
• Using menstrual products(pads, tampons, cups) as a gauge, you might use about 3-6 products per day.

Symptoms:

• Common symptoms throughout your menstrual cycle include cramps, bloating, breast tenderness, mood swings, and fatigue.
• These symptoms typically occur before or during your period and should be manageable with over-the-counter pain relief or lifestyle adjustments.

Consistency:

• Menstrual blood can range from bright red to dark brown.
• Small clots are normal, but they should not be larger than a $2 coin.

Things that can affect your menstrual cycle

• Certain types of birth control: Extended-cycle birth control pills and intrauterine devices (IUDs) will change your menstrual cycle. Talk to your healthcare provider about what to expect.
• Pregnancy or breastfeeding: A missed period can be an early symptom of pregnancy. Breastfeeding typically delays the return of your period after pregnancy.
• Eating disorders, extreme weight loss, or over exercising: Eating disorders such as anorexia nervosa, extreme weight loss, and higher physical activity can interrupt your period.
• Polycystic Ovary Syndrome (PCOS): People with PCOS may have irregular periods and enlarged ovaries containing small collections of fluid(follicles). These can be seen during an ultrasound exam.
• Premature Ovarian Failure: This refers to the loss of typical ovarian function before age 40. It might cause irregular or occasional periods for years.
• Pelvic Inflammatory Disease (PID): This infection of the reproductive organs can cause irregular menstrual bleeding.
• Uterine Fibroids: These growths in the uterus are not cancerous but can cause heavy and prolonged menstrual periods.
• Perimenopause: This is the transition period before menopause, usually starting in your 40s but can begin as early as your mid-30s. During perimenopause, hormone levels fluctuate, leading to changes in your menstrual cycle. 
• Stress: When you're stressed, your body produces higher levels of cortisol, often referred to as the "stress hormone." Elevated cortisol levels can interfere with the hormones that regulate your menstrual cycle, potentially causing various changes including flow, regularity, and delayed ovulation.

When to see a doctor

While variations in your cycle are normal, certain symptoms can indicate underlying health issues. If you experience menstrual issues that interfere with your quality of life, you should consult a healthcare professional.

Irregular cycles:

• Your cycle is consistently shorter than 21 days or longer than 35 days.
• You frequently skip periods or have periods more than once a month.

Excessive bleeding:

• You need to change pads or tampons every hour for several hours in a row, or
• You need to empty your menstrual cup/disc every 1-2 hours, or
• You need to change your period underwear several times a day, or if it's soaked through within an hour or two.
• Your period lasts longer than 7 days.
• You pass large clots (larger than a $2 coin) regularly.

Severe pain:

• Your cramps are debilitating and do not improve with over-the-counter medications.
• Pain interferes with your daily activities.

Unusual symptoms:

• You experience bleeding between periods or after sex.
• You notice a sudden change in your cycle patterns.
• You have severe PMS symptoms affecting your mental health (PMDD).

Other concerns:

• You have symptoms of anaemia (fatigue, dizziness, pale skin).
• You suspect you might be pregnant (missed period, nausea, breast tenderness).
• You have other symptoms that concern you, such as unexplained weight loss, excessive hair growth, or acne.
• Your periods suddenly stop for more than 90 days — and you're not pregnant.

How to talk to a healthcare specialist about menstrual issues

Prepare for your conversation with detailed information to ensure you receive an accurate diagnosis and effective treatment. This should include:

• A detailed record of your menstrual cycle: Including start and end dates, flow intensity, and noting the presence and size of clots.
• Symptoms: Any symptoms you experience during your menstrual cycle, including:
  • Pain: Location (e.g., lower abdomen, back), severity (mild, moderate, severe), and type (cramping, sharp).
  • Emotional symptoms: Mood swings, irritability, anxiety, depression, brain fog.
  • Physical symptoms: Bloating, gastrointestinal issues, headaches, fatigue, breast tenderness.
• Irregularities:
  • Frequency: Consistently shorter than 21 days or longer than 35days.
  • Skipped periods: Frequency and context (stress, significant weight changes).
  • Prolonged bleeding.
• Medical and family history:
  • Personal medical history: Any known conditions, previous surgeries, or treatments.
  • Medications and supplements: Noting any changes in medication or dosage.
  • Family medical history: Noting any history of menstrual issues or related conditions such as endometriosis or polycystic ovary syndrome.
• Lifestyle factors:
  • Diet and exercise: Noting any significant changes in diet or routine.
  • Stress levels: Major life changes or ongoing stress.
  • Sleep: Quality and duration of sleep.
• Questions and concerns:
  • Possible causes: What could be causing my symptoms?
  • Tests: Are there any diagnostic tests or examinations needed to diagnose my condition?
  • Treatment options: What are the available treatments or management strategies?
  • Long-term implications: Are there any long-term implications of these symptoms? 

Final thoughts

Knowing what’s normal for you empowers you to take charge of your menstrual health. Regular check-ups with your healthcare provider are essential, especially if you notice any changes or have concerns. Remember, you are not alone—many resources and professionals are available to support you.

About: This information was produced by The Period Place to help you understand and manage your menstrual health. If you have any questions or need further support, please visit theperiodplace.org for more resources and information on menstrual health.

Disclaimer: This information is intended for general educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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