Navigating the ups and downs of your menstrual cycle is not always easy. Whether it is the timing of your cycle, the nature of your cycle (e.g., light, heavy, erratic) or the presence of pain, every woman’s experience is unique. Sometimes, your cycle changes due to factors that are out of your control. For example, stress or sickness can change the nature of your cycle. Therefore, figuring out what is normal and what is not may require a little help. Let’s start by highlighting what a ‘normal’ period looks like.
Characteristics of a ‘normal’ period
First and foremost, it is important to note that the term ‘normal’ simply means normal for you. The best way to think about a normal period is to consider what a normal period looks like for you. This will differ for every woman. However, it is the variation from what you usually experience that may be considered abnormal.
Duration and Consistency
A regular menstrual cycle typically lasts between 21 and 35 days, with bleeding lasting around two to seven days. Although the duration of your period can change based on factors such as stress, illness and extreme exercise, a period will usually have this duration and consistency. If your period is erratic, usually lasts longer than 35 days or is shorter than 21, there may be an underlying issue.
Flow
Over the course of a period, on average, women will lose a small amount (two to three tablespoons) of blood. However, women who have menorrhagia usually lose twice as much blood and their periods last for longer than seven days. If you have bleeding that lasts longer than seven days or the bleeding is so heavy that you have to change your pad or tampon nearly every one to two hours, make an appointment to speak with your doctor. Excessive blood loss during a period should always be addressed.
Symptoms
Unfortunately, many women will experience symptoms around the time of their period. This includes mild cramping, bloating, breast tenderness and mood swings. While the duration and severity of these symptoms will differ, the presence of any symptoms that significantly interfere with your daily activities should be investigated by a doctor. This is especially true if you experience severe pain or cramping.
Timing
While inconvenient, a period that comes a few days late is perfectly normal and usually no cause for concern. In many cases, a late period is due to pregnancy, but as mentioned above, it’s not the only reason. Consider other factors, such as stress or illness.
What Is Not Normal?
Overall, minor changes to your period, such as flow, bleeding a little lighter or heavier than usual or passing painless blood clots, are common and do not require rushing to the doctor. However, the following characteristics of a period may warrant a trip to see one, especially if these characteristics are recurring or have worsened over time.
- Periods that last longer than seven days
- Periods with a very heavy flow—ie. needing to change a pad or tampon every one to two hours or less
- Periods that are erratic and come at inconsistent times
- Periods that are accompanied by severe pain
- Missed periods (and you’re positive you’re not pregnant). If you miss multiple periods or have irregular cycles for several months, it’s important to determine the underlying cause.
- Spotting small amounts of blood between periods
- Bleeding after menopause. This requires urgent consultation with your doctor.
What Causes an Irregular Period?
An irregular period may be caused by several common factors or conditions, such as:
- Changes to your personal health status -Stress, illness, weight changes or medication can all affect the timing and duration of your period,
- Polycystic Ovarian Syndrome (PCOS) – This medical condition is caused by an imbalance of the reproductive hormones estrogen and progesterone. In PCOS, normal regulation of these hormones is disrupted. This can lead to infrequent periods, heavy periods and periods that last a very long time.
- Endometriosis – Endometriosis is a medical condition in which the cells that normally line the inside of the uterus (the endometrium) instead begin to grow on the outside of the uterus. Common signs of endometriosis are very heavy periods, painful menstrual cramps and pain during sex.
- Fibroids – Uterine fibroids are another common cause of heavy periods, painful periods, and possibly bleeding in between periods. Fibroids are noncancerous growths of the uterus. They can develop over time and start to interfere with the normal cycle of your period.
When to see your doctor
Irregular menstrual periods should not be ignored, particularly if you have noticed one or more of the abovementioned symptoms. It is important to speak to your doctor so that they can evaluate your symptoms, perform necessary tests and provide guidance on managing any underlying issues.
Furthermore, if your period symptoms start to impact your quality of life or affect your ability to carry out daily tasks, this should also be discussed with your doctor.
The key message is if unsure, err on the side of caution and make an appointment.
References
- https://www.cdc.gov/ncbddd/blooddisorders/women/menorrhagia.html#
