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Care Credit

Ok, Ladies, Let’s Talk About Periods. Is Yours Normal? Read to Find Out.

January 21, 2016


Your period. The Red Menace. The Crimson Tide. Shark Week. On Your Moon. Being On the Rag. The Red Dot Special. Your Course. Aunt Flo. The Curse. The Monthly Gift.  The Monthly Bill.  Your Time of the Month. A Friend Coming to Visit.


What did I forget? What are your favorites? Some of them get pretty creative.


There are A LOT of euphemisms for menstruation. In our culture, talking about it openly is still taboo, period. (See what I did there?) So we’ve come up with some goofy ways to discuss this very regular thing that happens to half the population during most of their lives. We talk about our “monthly lady business” with our girfriends and female family members because we’re comparing notes on how we manage ours and trying to determine if ours is ‘normal.’ And also we want to commiserate about how it is messing up our vacations and any time, ever we need to be in a bathing suit. Ever.


Is yours regular? Is it normal?  Do you experience the average duration between cycles and bleed the average number of days and amount of blood, all with the average amount of discomfort?


First, a quick review. Why do we menstruate? (The answer is NOT because God hates you, but it MIGHT have something to do with Eve’s poor choices).


Every month, your body goes through a ‘cycle’ wheren the hormones produced by your ovaries and brain stimulate ovulation (release of an egg by the ovary) and stimulate the lining of your uterus in preparation for implantation by a fertilized egg. If, there is no fertilized egg to implant, the uterine lining will shed, and blood will come from the uterus out your cervix and into your vagina, where you will encounter it and possibly say some bad words. If you have ever been through fertility treatments or done natural family planning where you are tracking your cycle, you will know all about this and that there is a LOT more details to it than I have described here. If you are interested in more details, this is a good resource. It even has a cool little video.


There are many things that can interfere with your cycle- some we use intentionally, like some forms of contraceptives, and sometimes an abnormal period is a sign that something is not functioning as expected within your body and should be addressed by your provider. There are many examples of things that can affect your menstrual cycle- pregnancy, endometriosis, uterine fibroids or polyps, malnutrition, stress, early signs of menopause, significant weight changes, and possibly even a serious health condition.


What is the average cycle length? (Are you ‘regular?’)

Your cycle starts on “the first day of your last period” (there’s an app for that) and goes through the day before your next period starts.


Most people are fairly consistent from ages 20-40 and an average cycle lasts 28-35 days. In the first 7 years after menarche (when menstruation starts in life, typically around age 12) there can be a lot more variation in cycle lengths, and same goes for when you’re nearing menopause (around age 50), or the cessation of menstruation.


Contact your provider if:

*If your periods are coming sooner than every 21 days or less often than every 35 days

*If you are bleeding/spotting between your periods

*If your periods have previously been regular and are now irregular, or if you go >90 days without a known reason (pregnancy, contraceptives, etc)


How many days is the average menstruation?

2-7 days is normal, where most people average 3-5 days per menstruation. It is typical that the first few days will be heaviest and then will taper off.


Contact your provider if:

*You are bleeding more than  7 days per cycle


How much blood is normal to lose during menstruation?

Vaginal bleeding can appear to be a lot, but on average, we lose less than 80ml per cycle (for perspective- a can of soda pop is 355ml)


Contact your provider if:

*If you are having to change a pad or a tampon more than every 1-2 hours

*If there is a change in your cycle and you are bleeding heavier than you have or your heavy days are increasing in number

*If you are having signs of anemia- weakness, shortness of breath, light-headedness or fatigue


Are your menstrual cramps unusually bad? (Dysmenorrhea)

It is not uncommon to have menstrual cramps as your uterus contracts to shed the lining in the few days leading up to and including the first few days of menses.


Contact your provider if:

*If your cramps are not easily managed with heating pads, Ibuprofen/Tylenol products, and other conservative measures and the pain is interfering with your life

*If the pain is getting worse over the course of your cycles


Other reasons you should see your provider about your menstrual cycle:

*Any bleeding after sexual intercourse

*Bleeding after menopause (defined as 1 year without menstruation) MIGHT BE A SIGN OF CANCER AND SHOULD BE ADDRESSED IMMEDIATELY.

*You have not started menstruating by the age of 15

*You have not started menstruating within 3 years of breast growth

*You suddenly get a fever and feel sick after using tampons


Reminders about safe tampon use:

If menstrual products are left in place too long, you are at risk of getting a severe infection in your whole body (Toxic Shock Syndrome- TSS)
*You should change your tampon at least every 4-8 hours and remove before soaked with blood
*Use the lowest absorbency tampon necessary (the larger, super absorbency tampons increase your risk for TSS)
*Always follow instructions on the box
*GO TO THE EMERGENCY ROOM and immediately remove your tampon if you have a fever >102F, have muscle aches, diarrhea, vomiting, dizziness, sunburn-like rash, sore throat or blood shot eyes
This is a very basic rundown of what is normal and abnormal with a menstrual cycle. We could talk about this for days and still never cover all that there is to say on the subject or even scratch the surface of the comprehensive list of euphemisms people use to describe menstruation.
If you suspect that you have an abnormal menstrual cycle or have excessive bleeding or pain, please consult your provider. There are MANY ways we can help make your cycle an easier part of your life. Help us help you.
As always, please direct all specific questions about your health to your provider.
Be well!
sz, pa-c
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