As a woman, your period serves as a vital sign. Just like your blood pressure indicates heart health, your period can tell you about your hormone health and your fertility. Understanding what a normal period looks like will help you to better understand your body. When things get off track with your period, you will better understand the signals your body is sending regarding your hormonal health and your fertility.
Is My Period Normal?
Your period health goes beyond just your period. It’s more about your overall cycle health. A normal cycle can vary from one woman to the next. There are various factors to consider including cycle length, period length, period flow, bleed color and premenstrual symptoms.
Components of Your Period
Cycle length describes the duration of one menstrual cycle from the start of one period to the beginning of the next. In the first couple years of your menstrual life, your periods can be a bit more irregular with extended cycles lasting between 23 to 90 days. After puberty, a normal cycle can last anywhere from 24 to 35 days. While we think of a 28 day cycle as the golden standard, you can see that you can still be normal within this wide range.
Period length describes the number of bleeding or menses. As a teenager in your early menstrual life, your periods may be longer and heavier. A normal period can last between 3 to 7 days with an average of 5 days of bleeding.
Period flow can range from light to moderate to heavy flow. Within one period, you will typically have a variation of flow from moderate to heavy to lighter toward the last few days. Normal period flow ranges between 25 to 60 mL. This translates into about 5 regular pads or tampons up to 4 super pads or tampons. A regular pad or tampon can hold up to 5 mL and a super tampon or pad can hold up to 15mL.
Period color can also vary within one cycle or from one cycle to the next. A healthy period color can range from a pink color to a dark brown color. At the beginning or end of a period you may more commonly find a light red or pink color of bleed. In the middle of flow, you may see a variation from bright red to a brownish red color. All of these are normal. A brownish red discharge indicates a slower flow while a red period indicates fast flow.
Premenstrual symptoms include a range of symptoms that indicate the downward shifting hormones nearing your period. These symptoms can vary greatly in intensity and from one person to the next. Effects of PMS can include either or both physical and emotional symptoms. While some mild symptoms are normal, severe PMS or period symptoms that disrupt your daily life should be discussed with your healthcare provider and investigated.
Range of Period Symptoms
Emotional Symptoms of PMS:
Anxiety Sadness or crying spells Depressed mood Mood swings Irritability Poor concentration Changes in appetite Strong food cravings Trouble falling asleep or insomnia Change in libido
Physical Symptoms of PMS:
Muscle aches Low back pain Fatigue Headaches Weight gain Bloating Diarrhea or Constipation Breast Tenderness Acne
Signs of an Healthy Period
A healthy period can occur every 24 to 35 days and last between 3 to 7 days. The first day of a new cycle is counted from the first day of normal or heavy bleed. If you experience spotting for a day or two before heavier flow that is considered normal. But you will count the first day of heavy bleed as the official start of your period and cycle day 1 of the new menstrual cycle. Period flow can vary from light to heavy, though more commonly your flow will start heavier and lighten up the last few days. In the early days you will generally have more dark or red flow that then lightens up or turns more brown. Before your period, you may experience some signs of PMS in a variety of ways described above, but the symptoms should not be so significant as to stop you from functioning.
Signs of an Unhealthy Period
Irregular Periods
Irregular periods are a common sign of an unhealthy cycle. If you experience the occasional skipped or delayed period that is no cause for concern, but if you frequently experience irregularities in your cycles you should consult with your healthcare provider to investigate underlying causes. A cycle is considered irregular if there is a greater than 8 days fluctuation between cycles. If your last cycle was 25 days long and your next cycle is 43 days, that would be considered irregular.
Severe PMS
If you experience significant and debilitating PMS symptoms that cause you to miss days at school or work, then it is best to consult with your healthcare provider for any underlying causes, such as hormone imbalances, PCOS, endometriosis, or thyroid dysfunction. Severe symptoms include severe pain, disruptive mood swings and irritability and overwhelming fatigue.
Heavy Flow
A heavy flow of greater than 60mL is another sign of an abnormal period. If you require a tampon or pad change every 2 hours or less or more than 6 regular pads or tampons in one day that is a sign of a heavy period. Regular blood clots approximately the size of a quarter or larger in your period are also a sign of an unhealthy period. The occasional blood clot is normal, but consistently large clots in your period are not. If you experience any of these signs, it is best to seek a healthcare provider.
How to Manage Period Symptoms
How you manage your period symptoms will depend on the type of symptoms as well as the severity that you experience. There is no one solution to dealing with period symptoms or PMS. You can utilize a few different modalities to improve your experience. You can consult your physician for prescription treatment, apply dietary changes, modify lifestyle practices and use supplementation.
Depending on the severity of symptoms, your physician may consider hormonal contraceptives to help manage symptoms and debilitating pains. Modifying lifestyle practices can help. Right before and during your period, it is best to incorporate gentle movements like walking or yoga. Higher intensity exercise can add to inflammation and exacerbate period symptoms. Additional practices that help calm the body and lower inflammation include meditation or deep belly breathing, gentle massages and prioritizing sleep.
With an anti-inflammatory nutrition approach, minimizing foods that trigger inflammation or blood sugar elevation will help to improve some of the inflammatory symptoms of your period and PMS. This generally includes foods that are highly processed, include high amounts of added refined sugar, inflammatory oils, dairy and alcohol. To counter this, focus on adding more whole foods when possible. This includes foods like fruits and vegetables, nuts and seeds, whole grains and legumes and lean protein sources.
Foods to Include
Complex carbohydrates for fiber and energy
At least 2 servings of fruit
At least 5 servings of vegetables
Three regular meals a day
1-2 snacks according to what your body calls for
Healthy fats from fish, avocados, olives, nuts and seeds
Foods to Reduce
Intake of dairy (milk, cheese, sour cream, ice cream, etc) Refined sugars (baked goods, candies, processed foods) Alcoholic beverages Consider eliminating gluten
What Your Period Says About Your Fertility
If you are finding that you generally have a period every 26 to 34 days and you also experience signs of ovulation with mild and tolerable PMS and period symptoms, you are on track for good fertility. If you are experiencing a disruption of your daily life, very heavy period bleeds and irregular and unpredictable cycles, then it may be worth a trip to your physician to examine what the underlying cause is for you. Issues like fibroids, endometriosis, PCOS, gut problems and thyroid dysfunction can be underlying conditions that also affect your period health and fertility. If you are experiencing the above listed, you are most likely not ovulating. Even if you are not planning for a pregnancy, ovulation is needed for good fertility and is a sign of good general health, so it is important to pay attention to the signals your period is sending you about your health.
To learn more about using nutrition to improve your hormone health and fertility, contact Aida Sadeghi, MS, CNS owner of FeelGoodEats Nutrition. Schedule a free consultation call with FeelGoodEats Nutrition. Together we will design a meal plan that works for you and your unique lifestyle while providing everything you and your baby will need over the next several months.