Often women experience things or wonder about their cycle and are told that it is “common”. There is a big difference between what is “Normal” and what is “Common”.
It is common to have really painful periods, but it is not normal.
It is common to experience major PMS, but it is not normal.
It is common to bleed heavily, but it is not normal.
There are cases where you may regularly experience something in your cycle that has always been that way, and its normal for you – but if it interferes with your well being and your doctor just keeps telling you that its normal, seek out a different health care provider.
So what is normal anyways?
For the post pubescent adult female this is what you can expect for a normal period…
Normal is anywhere from 24-36 days. Contrary to popular belief that a cycle should be 28 days for everyone, a cycle that is regularly 35 days long is normal. Anything less than 24 days may just be because your follicle begins to develop early, but it also could mean that you are low in progesterone. A cycle that is longer than 36 days is often due to delayed follicle stimulation, which often occurs due to stress or illness. If you experience long cycles or go months without a period, its probably because your body is trying to ovulate but it can’t. This is not normal and should be investigated by a health care professional.
Bleeding should last between 3 and 7 days long and should start medium-heavy and progresses to light. Sometimes it is normal to have a lighter day before your heavy day. It is normal to have 1 heavy day, a few medium days and a few light days.
Spotting for a day or two before your period may be a sign of progesterone deficiency. If your period is short and light all the way through, you likely did not ovulate that month and instead you’re just having a shed due to falling estrogen levels.
Amount of blood
You should loose approximately 50 mls of blood throughout your entire period (10 fully soaked regular tampons, approx 3 tablespoons).
Less than 25 mls is considered a light flow, and may mean that you did not ovulate that cycle. Yes thats right, if your period is TOO light, thats a concern, as well! If you did not ovulate, you didn’t make any progesterone to help support the uterine lining, so when your estrogen levels eventually fall, you’ll have a small bleed but this is technically not a period.
More than 80mls of blood is a heavy flow, which you may want to have investigated due to the risk of anemia, as well as for other issues with regards to why you bleed so much (endometriosis, thyroid condition, hormonal imbalance). On this note, even if your bleeding is not quite 80 mls but is on the heavier side and you’re left feeling wiped during or after your period, have yourself checked out for anemia.
Quality of blood
When your blood exits your body, it should be bright red and then fade to light pink as the days go on. Brown blood is blood that has been oxidized (come in contact with air) and is a sign of old blood. If your blood is commonly brown when it exits your body (not when its been on your pad for a few hours, but when its fresh) you may want to consider improving pelvic circulation through movement and exercise, or even sex, to help flush out the old stuff.
Small clots can be normal especially on a heavier flow day, and especially if you have been sitting or lying down for a long period of time and then stand up. Blood will sometimes pools in the vagina and while it’s sitting there it will begin to clot. However, frequent, large clots are not normal and could be a sign of excess estrogen or endometriosis.
Spotting during your cycle is generally abnormal. It may be due to estrogen levels that are too low or too high, or if it occurs for a few days before your period, it may be a sign that you have low thyroid or progesterone levels.
Other causes of spotting can be caused by undiagnosed sexually transmitted infections, pelvic inflammatory disease, cervical hyperplasia or polyps, endometriosis or other abnormalities in the vagina or uterus.
Some people experience ovulation spotting, which looks like light spotting on the day of ovulation, which is normal. It may also be normal to experience some light pink bleeding after sex, especially if it was more vigorous than usual.
Where you can expect to see things a little different with your cycle include: From puberty – up until the age of 18, Post-partum or breastfeeding, and peri-menopause to menopause.
It is normal to have irregular periods in your teens (cycles can last up to 45 days long) and this is why its such a shame that doctors are quick to prescribe hormonal birth control for teens who want to regulate their period, because teens are 80% more likely to suffer from depression as a side effect of birth control, than adult women (1). The fact that a teens menstrual cycle does not regulate for a few years suggests that her brain also hasn’t finished developing either, making her even more susceptible to mental health disorders to begin with.
During the post partum period, you may experience some bleeding at 6 weeks as this is when the high levels of pregnancy hormones seem to decline. Breastfeeding also causes hormones to fluctuate in such a way that may result in some spotting but are not real periods. This is normal. After giving birth, the return of a period differs for each individual and it will depend on how long you breastfeed for.
At around age 40, your periods start to change and become less regular as you enter peri-menopause. This is likely due to the loss of follicles, which are needed for adequate hormone production. This is where hormone replacement therapy (estrogen) and bio-identical progesterone can come in handy, because the loss of hormone production can result in the awful side effects we all hear about being associated with menopause.
So, how does your period match up? Have you done something to improve your periods for the better? Share below!
FEMM teacher education training
Contraception Technology 20th revised edition, R. Hatcher, J. Trussell, A. Nelson, W. Cates, D. Kowal, M. Policar
Period Repair Manual, Lara Briden
Woman Code, Alisa Vitti
Taking Charge of your Fertility, Toni Weschler
(1) Skovlund CW, Mørch LS, Kessing LV, Lidegaard Ø. Association of Hormonal Contraception With Depression. JAMA Psychiatry. 2016;73(11):1154–1162. doi:10.1001/jamapsychiatry.2016.2387