Understanding Your Period: What's Normal, What's Not, and How to Find Relief

Understanding Your Period: What's Normal, What's Not, and How to Find Relief

Photo Credit: @juemwoman

You and your period. You’ve known each other since puberty; you’ve been through big emotions, awkward moments, and many Netflix marathons together. But do you really know why she’s here?

So much of what we’re taught about the menstrual cycle is often glossed over, or else reduced to the absolute basics: We bleed roughly once a month. It means we’re not pregnant. We get bad cramps and mood swings. But the reality is that our cycle is so much more than just our period—it’s a 28-day orchestra of hormones, sending messages to so many different parts of our body.

Our period is a symptom of this whole process—and while it’s crucial to understand what’s going on during the other 3 weeks of our cycle to get a full picture of our health, there is still a lot we can learn from the days we bleed. In fact, our period is really good at telling us when there’s an imbalance elsewhere in our body or routine.

With all this in mind, we thought it would be worthwhile to check in with Perelel Medical Co-Founder, Dr. Banafsheh Bayati, MD, OB/GYN, FACOG, to take a closer look at our periods—from the truth about PMS symptoms to what’s “normal.” Read on for her expert take.

    First things first: What is the purpose of a period?

    “Once menstruation starts, the lining of the womb develops with the rise of hormones at the start of each cycle,” Dr. Bayati explains. “The lining is formed in order to prepare for pregnancy implantation. If fertilization does not occur and hormone levels fall, then the lining is shed in response to dropping progesterone. Thus, a period is the body releasing the tissue that was built up each month in preparation for possible pregnancy.” 

    How long should our periods be? What's the range of “normal?”

    “Menstruation typically occurs every 21 to 35 days and can last for a few to seven days, typically,” she says. “Menstruation typically starts around the age of 12 but can occur as early as age eight or as late as age 16, and for the first several years, cycles may be more irregular. In general, cycles tend to shorten and become more regular with age.”

    What does it mean if your period is too long or too short?

    “If your cycles are irregular, then it is best to be evaluated,” says Dr. Bayati. “There are many causes for irregular periods depending on the woman’s age, her personal and family history, as well as her diet and environment.” Stress and hormonal birth control can also have a role, as these are external factors that impact our hormones.

    What if your period is missing? Outside of pregnancy, what could that point towards?

    First, you’ll want to rule out pregnancy. “Then a full evaluation is needed to address possible issues such as stress and illness,” she says. “There are many other causes including medications, hormonal imbalances, weight changes, eating disorders, and poor nutrition.”

    Why do PMS symptoms come on before your period?

    “PMS stands for premenstrual syndrome,” notes Dr. Bayati. Contrary to popular belief, these are symptoms that occur before your period, during your luteal phase. (The luteal phase is the second half of your menstrual cycle following ovulation, and typically starts 14 days prior to the start of your period. Your PMS symptoms should actually start to go away as soon as your period starts.

    “PMS includes both physical and emotional symptoms that women can experience following ovulation, as the hormonal levels of both estrogen and progesterone peak and begin to fall,” she adds. “These changing hormone levels may affect some women more than others.” These common symptoms of PMS include mood swings, breast tenderness, food cravings, cramps, lower back pain, and bloating.

    At what point are PMS symptoms abnormal?

    “For most women PMS symptoms are mild,” says Dr. Bayati. “But for some, they can be severe and affect their life. Typically, this is called premenstrual dysphoric disorder or PMDD. PMDD can cause severe irritability, depression, or anxiety starting one to two weeks prior to each cycle start.”

    In other words—some mood changes are normal, but if you’re feeling particularl low or your feelings feel huge and out of control, it may be worth getting checked out for a potential imbalance. “It is possible that PMDD is linked to serotonin levels in the brain as these levels change throughout the menstrual cycle and some women may be more sensitive to these changes,” Dr. Bayati says. 

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    How much bleeding is in the normal range?

    “It is typical to bleed anywhere from five to 80 ml of menstrual fluid each cycle with averages at 30 to 60 ml per cycle,” says Dr. Bayati. (That’s about the equivalent of 3-5 tablespoons, or roughly 1/4 of a cup.)

    That said, there are a few warning signs to look out for: “If you are passing large blood clots each cycle, have to restrict your activity for days each cycle, experience severe fatigue or other symptoms of anemia, soak more than one tampon each hour for several hours each cycle or use double protection such as tampons and pads to prevent leaking, then you should see your doctor and assess your cycles for heavy bleeding,” she says. The same goes for severe pain—painful periods are not a normal thing to suffer through, and are actually a sign of a condition called dysmenorrhea.

    Are there any unexpected symptoms that may arise with your period?

    “It is definitely common to experience digestive issues such as diarrhea, constipation, bloating and gas with menstruation,” says Dr Bayati. (Yep—period poops are a thing.)

    “This is often due to a rise in hormones called prostaglandins, which help the womb contract and shed its lining as well as to contract and stop menstrual bleeding.”

    How can we find relief from common PMS symptoms?

    In general, it’s a good idea to adjust your routine according to where you are in your menstrual cycle: So if you’re entering your luteal phase (those two weeks before your period starts), you might start to transition into gentler habits like low-impact exercise, take proactive steps to support your mental health, and just be cognizant of what’s happening in your body. As you get closer to the start of your period, you can relieve painful cramps with a heating pad, warm bath, or ibuprofen; you might fight off bloating or fluid retention with supplementation, and log an hour or two more of sleep each night to keep tiredness at bay.

    In the end, remember that you know your body best—so if something feels off, wrong, or painful, don’t be afraid to get input from a healthcare professional.

    Did we miss any of your period questions? Nothing’s off the table and no question is too basic or specific. Tell us on social or by dropping us an email. 

    This article is for informational purposes only. It is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and we recommend that you always consult with your healthcare provider. To the extent that this article features the advice of physicians or medical practitioners, the views expressed are the views of the cited expert and do not necessarily represent the views of Perelel.

    Written by Jessica Lopez. Jessica Lopez is a freelance writer, digital content creator, and new mother. She has covered all lifestyle topics ranging from bridal to beauty for publications including Brides Magazine, Byrdie, THE/THIRTY, and more. Walking wide-eyed into motherhood has inspired her to connect with other parents through her writing and shared experience. You can follow more of her journey @Jessica.H.Lopez.