Menstrual Health: What You Need to Know About Your Periods

Whether you know it as “That Time of the Month,” “Aunt Flow” or “The Crimson Wave,” one thing’s for sure – as women, periods and menstruation are a regular part of our lives. While menstruation can look different for every woman, the heaviness, regularity and pain associated with your monthly cycle can alert you to potential problems with your ovulation, hormones and reproductive system.

Menstruation – A Woman’s 5th Vital Sign

You’ve probably heard the term “vital sign” before. It’s what doctors refer to as signifiers that tell them whether the body is functioning well or whether there is a problem that needs to be investigated. The four main vital signs are your respiratory rate, pulse, body temperature, and blood pressure. If someone’s temperature is out of the normal range and higher than usual, a healthcare provider may suspect that there’s an infection present in the body and conduct various tests for diagnosis.

Likewise for women, your menstruation serves as your fifth vital sign. Any irregularities in your menstrual cycle should be discussed and addressed with your Certified Nurse Midwife (CNM), OB-GYN or other healthcare provider, who can help you identify potential underlying causes.

What does normal menstruation or a “normal period” look like?

You can find a brief description of the typical period and what happens to the lining of the uterus throughout your cycle on the American College of Obstetrics & Gynecology website. Here are some basic facts to know:

• The first day of menstrual bleeding (your period), is the first day of your menstrual cycle.
• Cycle length is measured from the first day of one menstrual period to the first day of the next menstrual period.
• Twenty-eight (28) days is the average length of menstrual cycles though they may vary between 21-35 days.
• Bleeding typically lasts 7 days or less, with some days of heavier blood flow and some lighter days. Using several pads or tampons in a day during a heavier day of bleeding is normal.

What are signs of an atypical period (also known as abnormal uterine bleeding)?

Menstrual periods can be outside of the normal range in several ways and for many reasons. Here are some of the major signs to look out for:

• Bleeding that lasts for longer than 7 days
• Bleeding that is so heavy that it soaks one or more tampons or pads in an hour
• Menstrual cycles (the start of one menstrual period to the start of the next) that are irregular for a woman (differing more than a week)
• Menstrual cycles that are less than 21 days or more than 35 days
• Bleeding that occurs between menstrual periods
• Excessive pelvic pain or cramping during menstruation

Since every woman’s period can look different, it’s important for you to note and track what is normal for you and your menstrual cycle. You can track the days you have blood flow, whether it is heavy, moderate, light or spotting, and if you have any symptoms such as cramping through either a journal or calendar or via an app on your phone. If you notice abnormal bleeding, it will be much easier for your healthcare provider to help you explore possible causes when you can give them information from your past menstrual periods.

*Please note: We understand that some women do not feel comfortable tracking their periods via an app due to privacy concerns. You should track your periods however you feel most comfortable doing so.

What are some possible causes of atypical periods?

There are many potential causes of abnormal menstrual bleeding. Some of these include:

• Uterine fibroids – a growth of muscle in the uterus that is not cancer
• Polyps – a growth of tissue that is not cancer, inside the uterus or on the cervix (opening of the uterus to the vagina)
• Medications – certain medications and types of contraceptives (including IUDs and hormonal contraception) can impact menstrual periods
• Irregular ovulation (release of an egg) – there are many reasons for abnormal ovulation because regular ovulation only happens when your body’s hormones are perfectly in sync. Some of these reasons can include high levels of psychological stress, changes in eating habits, polycystic ovary syndrome (PCOS), thyroid problems, and endometriosis
• Infections, pregnancy, miscarriage, and pre-cancerous or cancerous cells can also cause abnormal bleeding

How to get treatment for period irregularities

Because there are so many potential causes of abnormal menstrual bleeding, it is important to work with someone who is trained to explore potential causes and help with treatment. Diana Health’s Certified Nurse Midwives (CNM) and OB-GYN physicians are experts in women’s healthcare and helping women with periods that are not normal. We’ve made it easy for you to book an appointment online!

When you visit Diana Health for your annual well woman visit, your provider will ask you about your menstrual periods so that they better understand what “normal” looks like for you, any changes you’ve noticed, and your unique medical history. Sometimes ultrasound imaging or blood tests are needed to look for the root cause of your menstrual irregularity.

If you have questions or feel like your period is not normal or you’re having any problems (including pain), please reach out to us and schedule an appointment! You don’t have to wait for your annual exam and you shouldn’t put off getting a quick check up. Call us today to schedule an appointment. Don’t ignore your 5th vital sign. If something is not normal, it’s important to address it now.

After your provider understands what is causing the abnormal bleeding, they can work with you to decide what to do for treatment. Often there are multiple options. Sometimes there is a risk of doing nothing and sometimes there is not. Regardless, it’s important to have this discussion with a healthcare provider with expertise in this area. You deserve it!

For more information ACOG has a great resource you can explore.