The topic I want to dive into today is what is a healthy menstrual cycle? So many women are misinformed about what they should expect from their menstrual cycle and if what they are experiencing is normal or not.
It’s a little known fact that women can use their menstrual cycle as a barometer of their health. In fact, the menstrual cycle is now starting to be considered as the fifth vital sign of a woman’s health. The first four vital signs are: heart rate (which is your pulse), body temperature, blood pressure and breathing rate etc. These are the four signs that are checked if you are in an emergency situation and also on regular doctor visits and can be a sign that something is not right.
What I have learnt in recent years and firmly believe is that: the menstrual cycle is a window into your general health and well-being as a women, and not just related to whether or not you can get pregnant.
If you are not having a regular cycle with ovulation, then that could impact on your heart health, bone health as well as your long term fertility.
So let’s take a look at what a healthy cycle should look like.
Bear in mind that your menstrual cycles will vary at different stages of your life. During pregnancy and breastfeeding it’s normal not to have a cycle, however at other stages of life, if your period has gone missing, it’s worth investigating what is going on in your life that has caused it as it is a sign that something is not right. It could be related to stress, body weight or another medical issue.
Firstly, How long should your cycle be?
Before I talk about cycle length, I want to make it clear that we are all counting the same thing. The first day of your cycle is the first day of bleeding. If you experience spotting before proper bleeding then you can choose the spotting as the first day of bleeding as long as you are consistent every month to what you consider the first day of your cycle. Some women don’t include the spotting and count Day 1 as the first day of proper blood flow.
The average cycle length is around 28 days. There is a strong correlation between the moon and the menstrual cycle. The average lunar month is 29.5 days. However, it’s quite possible for your cycle to last for anywhere from 21 to 45 days and still be considered normal. 45 days is definitely on the long side and most health professionals will prefer to see cycle length of less than 35 days. The important point is that your cycle length is roughly the same each cycle and cycle length doesn’t vary more than a week.
So to put that in numbers, you might find that generally your period is 30-31 days apart but you have one or two cycles in a year where your period arrives after 36 days or 35 days. That’s considered normal as there are factors that affect when you ovulate and when your period arrives. Ideally that difference between cycle lengths is going to be less than a week and even better if the difference is only a few days. That’s a sign that the hormones in your body are working optimally.
What can affect the length of my cycle?
If you are having cycles of vastly differing lengths then you need to pay attention to what may have caused it. Stress, moving, illness, a change in nutrition and exercise can impact your cycles and possibly delay ovulation and cause a longer than usual cycle.
One of the advantages of using Fertility Awareness is that you can make note of any changes in your routine on your chart and see how it affects cycle length, ovulation, etc.
If you’ve been charting and note that your ovulation has been delayed, that’s going to give you a heads up that your cycle will be longer than usual this month. And that can be so helpful so you’re not panicking and stressed because your period is late.
Even if you aren’t using Fertility Awareness yet, just being aware of your cycle length and noting down your mood, lifestyle changes, etc can give you some important clues about your cycle.
How can we discuss your period without talking about blood!?
Moving onto some more nitty gritty details: how can we discuss your period without talking about blood!! Firstly, a true period is bleeding that occurs 2 weeks after we ovulate. This is an important point to mention because women do bleed while they are taking the pill and some other forms of hormonal contraception but that is not considered a true period. A true period is always preceded by ovulating a couple of weeks before the bleeding starts.
I mentioned earlier the incidence of spotting. It is a common occurrence but Ideally there shouldn’t be spotting. That can be a sign of imbalanced hormones.
Colour should be a variant of red: pink to a deep wine colour. But it shouldn’t be brown black or purple is not normal. A small amount of clots or strings of blood is considered normal but not too much. Ideally you want to be seeing liquid blood without clots.
What is considered a normal flow pattern?
One issue of periods that is rarely discussed is the actual Flow pattern of bleeding. There are two normal patterns: the first is a crescendo to decrescendo pattern where the bleeding moves from light to heavy to moderate and then back to light again before ending.
The second pattern is it starts out heavy, stays heavy, then moderate then light before ending.
An Abnormal flow stays the same for days on end.
Also the flow should be fairly consistent. It shouldn’t stop completely and then restart.
How long is the bleeding supposed to last?
If a woman was having 7 days of heavy bleeding, then that would be cause for concern. It may surprise you to know that the average amount of blood lost during your period is 30mls which is actually not that much when you think about it. Anywhere up to 80mls is considered normal blood loss during one period. If you’re losing more than 80mls during your period, that would be considered heavy bleeding.
If you’re interested in checking how much blood you lose next time you have your period, the easiest way is with a menstrual cup. Many of them have measurements on the actual cup so it’s very easy to measure. If you’re using a tampon or pad, you can check the information on the box, It should say what volume of liquid it holds. The average pad or tampon holds 5mls which is a teaspoon of liquid. So you can just count how often you are changing a fully soaked pad or tampon. How often you need to change your tampon, pad or menstrual cup with give you an idea of how much blood you are losing.
In one study I read they found that women who are taller, have had children and are in perimenopause have the heaviest flow.
Secondary symptoms: Breast tenderness, mild menstrual cramps. Mild lower back pain, minor changes in digestion and minor bloating are normal physiological responses to the changes in hormones in your body. The emphasis here is on minor. When it starts to impact your life, the pain is at the level that you need to take pain killers, then it’s worth checking to see if there are some holistic approaches to reduce the discomfort and pain.
However, although period pain is common it’s not normal. Periods are not meant to be painful and there are many holistic treatments that can prevent painful periods. I am trained in the Arvigo techniques of Maya Abdominal Massage and I frequently work with clients to relieve period pain. Many women are shocked that they don’t need to suffer each time they have a period and even more shocked when within a cycle or two the pain is gone or significantly reduced.
If you are experiencing painful periods to the extent that it’s interfering with your life, I highly encourage you to get some help. When you think about the average number of cycles you will experience in your life, it makes sense to improve your quality of life and get some help sooner rather than later.
One of the most significant changes during the cycle that women experience is change in their Moods. It is normal to experience different emotions throughout the month. There is a lot of very interesting discussion in recent years about the connection between our cycles and the seasons of the year. you can really see how each week in our cycle can be compared to a season. Just like we experience different weather in different seasons, we also experience different moods at different times of the month and that is 100% normal. You do not have to be happy, sociable and energetic the entire month. Having days when you feel like you need to retreat, days when you are a bit moody and want to be alone or touched less and days when you are feeling more energetic and able to be more social and productive is totally normal. Don’t let anyone tell you otherwise. Women are cyclical creatures!! And we need to embrace that.
Having said all that, radical mood swings are another sign of imbalance. If your changing mood are impacting your life to the extent that you feel they are really interfering with your day-to-day life, I recommend that you reach out and seek medical help.
I mentioned earlier that your cycle will most likely be different during different stages of your life. So firstly, in the first 5 years after you get your period, you can expect more cycle abnormalities.
For the first 5 years after your first period, your eproductive system and hormones are changing and developing. There is a delicate feedback system that can take a little while to develop. Cycles lengths of 21- 45 days are considered normal. It’s also normal if there are skipped periods and up to 90 days without a period is not a cause for concern. However if it goes over 90 days, then you should check with a medical professional. Period may only last for 3-7 days and might be a little lighter regarding the volume of blood.
If you got your first period after the age of 14, it may take up to 8 -12 years until normal ovulatory cycles . So that could mean that if you started your period at age 16, your cycles may not naturally regulate and normalize until the age of 24!!!
It’s quite common however for young girls or women in their late teens and early twenties to be given birth control pills in order to regulate their cycles. This practise is unfortunate because the use of hormonal birth control during this development period can actually stunt a woman’s reproductive development and cause issues further down the road. It would be much better to try to find out what the underlying cause is and trying to heal that.
Pregnancy and Your Cycle
Let’s talk about pregnancy and how that can affect your cycles. And when I talk about pregnancy here I am also including miscarriage and abortion. I’ll discuss breastfeeding in a moment. But if you’re not breastfeeding, you should expect a fairly fast return to fertility.
After the end of a pregnancy it can take 3 cycles to get back to normal cycles. If your period hasn’t started again within three months of the end of the pregnancy and you’re not breastfeeding, then you should consult a medical professional.
However, if you gave birth and are breastfeeding, that would explain why your period hasn’t returned. Prolaction which is one of the hormones released when you breastfeed suppresses ovulation.
That isn’t to say that you can’t get pregnant while you are breastfeeding! You definitely can and there are natural ways to prevent pregnancy during this time but that’s not our topic for today. I just share that so there won’t be any confusion about the possibility of conceiving while you’re breastfeeding.
Birth Control and Fertility
One other confusing period in a woman’s life can be when she stops taking hormonal birth control and what happens to her cycle. For the sake of simplicity I’m just going to say the pill but I am referring to all kinds of hormonal birth control.
It is a little known fact that it can take 6-12 months for your cycle to regulate after you stop taking hormonal birth control. And it can be up to 18 months after the last Depo shot.
Many women are quite shocked when they hear this because they are stopping birth control in order to conceive and want to get pregnant as soon as possible.
What you can expect after stopping the pill is either longer or shorter cycles that normal, periods may be lighter or heavier for the first few cycles. There is a wide range of normal here. For women who have been charting using Fertility Awareness during this stage they can actually see some of the changes happening in their bodies that show that their fertility is returning to normal and healthy and that can be very encouraging when on the outside it looks like nothing is happening.
Once your fertile years are coming to a close, you will eventually reach menopause:
Menopause is when you haven’t had a period for one year (obviously excluding pregnancy or another reason as the cause) The average age of menopause (when your period ends) is 51 years. However, many women experience symptoms related to menopause five to ten years before their periods end. And bear in mind that since 51 years is an average, some women are experiencing menopause in their early forties while other are still having their periods during their 50s right up until the age of 60 or later.
Periods can be very frequent even as often as every two to three weeks and they can also be very long with months in between periods. The bleeding itself can be heavier or lighter.
So now we’ve covered what a healthy cycle looks like and briefly addressed issues like pregnancy, menopause and stopping hormonal birth control, you may be asking yourself “How would you know if there is a problem? “
If you’re a teen, recently come off of hormonal birth control or recently pregnant or peri-menopausal then these guidelines don’t necessarily apply.
For everyone else, you can ask yourself if your cycles are outside of the ranges I’ve discussed here.
- Frequency of your period is less than 24 days or more than 40 days
- You don’t have a period for six months
- Your Cycle length changes more than 20 days, so one month it’s 26 days and then its 47 days in length
- Period length is less than 4 days or longer than 8 days
- You have More than 3 days spotting before your period
- You have More than 2 days spotting at the end of your period
- Your bleeding is really light less than 10mls
- Your bleeding is really heavy more than 80mls
- You fully soak a tampon or pad every 1-2 hours
- You have unexplained Spotting between periods
- You have moderate to severe period pain
- You have moderate to severe ovulation pain
If you are experiencing one or more of these issues with your cycle, I encourage you to be in contact with me. These are issues that I address in my clinic all the time using Arvigo, reflexology and other tools to bring women back to balance. Remember your cycle is a reflection of your overall health.