Let me just start by saying this blog is going to be graphic. Not intentionally gruesome but if blood and periods aren’t your thing maybe try a different blog. However, if you are in the vast majority of people on the earth that bleed monthly this might be right up your alley. I personally think this is a health area that is not talked about enough and over mystified, causing a lot of women to struggle unnecessarily due to fear of embarrassment. As a Chinese Medicine Practitioner we use periods as a very important tool for gauging a women’s overall health, so much so that we jokingly refer to it as the “monthly report card” when assessing our clients…it’s that important!
Here are 7 of the main factors to consider when trying to figure out whether your period is normal or healthy:
- Cycle Length: Most people have heard that from the start of one period to the start of the next should be 28 days, however not everyone has an exact 28 day cycle. If you are bleeding every 26-32 days regularly and this has always been your pattern, then that is perfectly normal. If suddenly you have a change in the length of your period and they are getting shorter or longer it may be the indication of an underlying issue such as perimenopause, Polycystic Ovarian Syndrome or stress. After stopping the OCP (oral contraceptive pill) or having a baby the menstrual cycle can take a long time to regulate, anywhere up to a year. This is due to the changing hormone levels within your body and is very common for most women.
- Bleed Length: The average woman bleeds between 2-7 days. This can range from light to heavy bleeding and should stay consistent from month to month. Ideally at a bare minimum a healthy period requires at least 3 days of bleeding. This means you have built up enough of an endometrial lining to have a healthy flow and if desired implant an embryo. If you are bleeding lightly for 3 days or less, it may be worth getting your iron levels tested to ensure you have adequate stores for a good flow. Bleeding heavily for more than 7 days (heavy bleeding is classified as changing your pad or tampon hourly) is classed as menorrhagia. Iron levels need to be tested in this instance as well because someone who is bleeding heavily for 7 days is likely be very depleted, even if they are eating steaks every day! Excessive bleeding can be caused by a variety of gynaecological conditions including endometriosis, Polycystic Ovarian Syndrome, fibroids and contraception devices such as the IUD. In Chinese Medicine a lighter bleed is generally due to a blood deficiency while an excessive bleed can be due to a Qi or Spleen deficiency.
- Pain: This is a really interesting factor to consider and one that can be debilitating. Contrary to popular belief, there is no such thing as “normal” period pain. In a perfectly balanced individual who is eating an anti-inflammatory diet and exercising it’s possible to have no pain at all! In saying that period pain (dysmenorrhoea) is very, very common. Most of us have suffered from period pain or cramping at some point and it is generally not pleasant at all. The pain comes from prostaglandins (chemicals) in the lining of the uterus that are released during menstruation. These hormones cause all sorts of wonderful things such as diarrhoea and nausea (more on that later) and can be debilitating to some women in the early days of the cycle. Excessive pain during menstruation can be linked to endometriosis and fibroids. The good news is, like all hormones, there are things we can do to limit their release therefore limiting the impact of pain on our everyday lives. By decreasing inflammation during this time and ensuring that certain vitamins and minerals are kept at a high level there are ways to get through a period grief free.
- Clots: Clots are a very common symptom of periods. Clots form when the blood in your uterus is being shed more quickly than the anticoagulants (hormones that help break down the tissue and blood) can be produced. Clots are small clumps of blood and endometrial tissue that can be dark or bright red. Generally speaking clots are perfectly normal and you don’t need to worry about them but if they are larger than a 10 cent piece you may get increased pain during your cycle. Large clots can also be associated with an underlying gynaecological condition such as endometriosis, PCOS, fibroids or a possible miscarriage. In Chinese Medicine clots represent blood stasis which is exacerbated by stress, so an increase in clots for certain cycles often correlates with a particularly stressful month.
- PMT: Premenstrual syndrome is a group of symptoms that women typically exhibit leading up to their period. Symptoms can begin immediately following ovulation or just a few days before the period is due to arrive. These can include breast tenderness, irritability, migraines, acne, anxiety, low libido, weepiness, increased sensitivity fluid retention to name a few. All glorious by nature and for a lot of women much more uncomfortable then the bleeding stage of the menstrual cycle. For a staggering 8% of women this stage of their cycle limits quality of life and is classed as the much more severe PMD (Pre-Menstrual Disorder). During this time of the cycle it is imperative that women exercise to move around stagnation in their body and increase the levels of magnesium in their body (either via supplementation or diet).
- Ovulation: Ovulation is the release of an egg from one ovary once a month. It typically happens 14 days from the end of your last cycle. Once you know what you are looking out for it’s relatively easy to see when you are ovulating. For 3-7 days during this time you will notice a change in discharge from watery to egg white consistency. Although being slightly confronting to deal with this is a wonderful sign that you are ovulating and therefore your health is on track. If you are using Body Temperature Charting you will notice after you ovulate a significant rise of approximately 0.4 of a degree that signals the egg has dropped. Another very common sign is a high sex drive, this is evolution’s very clever way of ensuring the survival of the human race as this is the time you can conceive.
- Digestive changes: Like we mentioned before prostaglandins are the lovely hormones that cause pain during a period. They also ensure another delightful set of side effects in the gastrointestinal family. Diarrhoea and bloating are caused by an increased release of prostaglandins in the bloodstream, most commonly seen with the start of the menstrual cycle. as well as pain and bleeding a lot of women suffer from diarrhoea as soon as they start their menstrual cycle.
Right so that’s it. Hopefully you have noticed as you have read through this list that a lot of what is going on with you is perfectly normal and natural. It’s also important to remember if you are on any type of contraception a lot of these signs and symptoms will be masked by the synthetic hormones.
What I have described is the norm for the majority of women but we as health practitioners are always striving for extraordinary. To help you understand what we are attempting to achieve, this is a description of the world’s perfect period (yes there is such a thing).
A perfect period is one where you don’t realise it’s happening, one where you are going about your day and when you go to the bathroom you notice you cycle has started with no pre-emptive warning 28 days after the last cycle. Following that you continue to function like a normal human as you bleed between 3-5 days with no disruption to your life whatsoever, no pain or urge to eat a family sized block of chocolate for breakfast, lunch and dinner. 14 days after you begin bleeding a single egg will drop from one ovary without much fanfare and cause some cervical mucus for 2-5 days. You will either implant an embryo and make a baby (if that’s your aim) or not (if that’s your aim). After ovulation your temperature will raise slightly until you begin to bleed again approximately 14 days later.
Unfortunately, this is a very unlikely and uncommon scenario, due to the hectic pace of our modern lives, dietary factors, stress levels and environmental toxins but one we as health practitioners are always striving for. In conclusion, unless you are a natural goddess who eats organic grass-fed meat and vegetables, meditates 3 hours a day and does yoga at sunset and sunrise chances are you are not having the perfect period. Luckily I know a great acupuncturist who may be able to help 😉