That is 400 cycles of changing hormones impacting your mood, energy, appetite, sleep, and productivity. Yet, most of us were never taught what a "normal" period actually looks or feels like ... especially in an age-appropriate way.
This is the unfortunate reality for so many of us women and menstruators!
We learn the Periodic Table in school, but we don't learn the periodic realities of our own bodies.
I normalized my own VERY irregular menstrual cycles (sometimes 30 days, sometimes 45 days, sometimes MIA for months at a time) because I didn't know I was supposed to get a period monthly. In my case, it turned out to be PCOS (polycystic ovary syndrome).
Similarly, so many people normalize missing school/work/life because of period pain.
Or, normalize extreme mood swings before a period.
Or, flooding through multiple period products like pads AND tampons within an hour.
Your cycle isn't just the days you are bleeding. It is a communication system between your brain, ovaries, and uterus. If we're getting technical, the menstrual cycle has 2 phases separated by 2 events: the period kicks off the follicular phase, while ovulation kicks off the luteal phase. Generally , we usually divide the menstrual cycle up into 4 parts:
"Normal" is a range, but there are medical definitions we can use as a baseline. If you fall outside of these, it’s a sign to investigate further.
Flow: The average is a loss of 30-50mL of blood over the entire period, although between 10 and 80mL is considered normal. If you use a cup or disc, check the markings. If you use a pad or tampon, a regular-sized product holds just over 6mL. Some small clots are considered normal too! Not Normal: soaking through a pad or tampon every hour, doubling up on products, passing clots >1" or quarter-sized regularly
Duration: Bleeding for 3 to 7 days. Not Normal: Bleeding for fewer than 2 days or longer than 8 days regularly.
Pain Levels: Some feelings of pressure, heaviness, or discomfort are normal due to inflammatory compounds inherent to your period starting! Not Normal: "Curling up in a ball and cancel life" pain. If you need heroic doses of painkillers, are missing work or school, and/or are having vomiting-levels of pain, that is not normal and could be a sign of endometriosis or fibroids.
From the end of one period to the beginning of the next period, the name of the game is change. Your estrogen rises, triggering ovulation through a surge in LH (luteinizing hormone). This then leads to an increase in both estrogen and progesterone. Then, when the body realizes that pregnancy didn't happen, your hormones drop to trigger another period.
All of these ups and downs in hormones can lead to some very real changes in how you feel like:
These are normal responses to fluctuating hormones. But, you may have exaggerated or severe symptoms, which really does warrant a proper investigation, discussion, and plan. I go through all of this in an episode of Phase to Phase: The Hormone Health Show all about what a normal menstrual cycle looks and feels like, go listen now!
If you're more of a reader (or know a bookworm), then grab my book, The Period Literacy Handbook in paperback, ebook, or audiobook here.
The foundations of your health–like sleep, stress management, nutrition, exercise, iron status, and connection–are all important aspects of your menstrual health and your resilience to hormone change. You may need additional support from medications, hormones, supplements, contraception, acupuncture, and counselling, depending on your health, diagnoses, age, goals, values, and lived experience.
I have SO many great discussions about health and hormones, including very tough medical decision-making, with women across Ontario, Canada in my practice. I see patients with general hormonal health concerns, with PCOS, endometriosis, perimenopausal symptoms, postmenopausal concerns, vaginal dryness, infertility, adenomyosis, PMDD, and so much more!
From the first period ever until the final one before menopause, there's so much that changes. Each one of us goes through our own journey!
Make sure you're tracking your cycle so that you can get a pulse on YOUR nuances. Here's a blog post to help you get started. This way you can also share what's going on with your health team and ask them any questions you may have.
When you go to your doctor, you can move from saying, "My periods are terrible" to saying, "For the first 2 days of my cycle, I soak through a super pad every 90 minutes and my pain is an 8/10." That specificity makes it much harder for a provider to dismiss you!
