Your 7 helpful points about periods
But what is normality, really? It's simple, there is no such thing as normal. We are all unique and each one of us experiences very different cycles.
Here we will see what is considered as signs (objective indication for example diarrhea) and symptoms (subjective indication for example pain) healthy and not worrying to better monitor you and prevent potential disease.
Menstruation or period is a physiological period, which is an integral part of your body's healthy functioning when there is no fertilization.
The blood flow is due to the elimination of the mucous membrane, called "endometrium", which fills with blood during each cycle and lines your uterus (the part of the reproductive organ that can accommodate an embryo: future fetus and baby).
Potential pain can be felt during menstruation, this pain is related to the contractions of the uterus, carried out to evacuate the endometrium when there is no fertilization.
1. Evolution of menstruation
- Average age of first menstruation: 12.6 years1, arrives earlier and earlier for reasons unknown at the moment. According to INSERM2, greater exposure to UV rays may lead to earlier menstruation.
- Duration of menstruation: 2 to 8 days
- Cycle: Number of days between your periods
- Abundance:
Low: low intensity bleeding = Hypo menorrhea or Oligo menorrhea: 30mL total = 2 to 3 pads per day
Medium: 50mL in total = 4 to 5 pads per day
Intense: or Menorrhagia (See below for more details): 80mL in total or 6-7 pads per day = consultation with a gynecologist!
- Frequency: menstruation every month or presence of amenorrhea (see below for more information)
- Regularity: menstruation occurs within 5 days of previous cycles
- Pain: Intensity/Duration/Location/Solutions used = varies depending on the person = more details below Click here for our best tips to relieve painful periods!
- Signs and symptoms accompanying the cycle: note when you have them in the cycle, its intensity, duration, solutions used: breast tension, mood change, insomnia, diarrhea, constipation, backache, headache
Visit our site entirely dedicated to the relief of menstrual pain!
2. Premenstrual Syndrome (or PMS)
PMS is a common disorder (20 to 50% of menstruating people), occurring 7 to 10 days before the first day of menstruation and ending a few hours after the first day of menstruation.
Visit our site entirely dedicated to the relief of menstrual pain!
Most often presents with:
- Labile mood (unstable, variant)
- Anxiety
- Depression
- Intense fatigue
- Insomnia
- Transient weight gain
- Breast pain/tension: wrap them in fresh salad leaves/cabbage that can soothe, wear an adapted bra
- Difficulty concentrating
- Lumbago: pain in the lower back
- Edema: often in the legs: raise your legs as much as possible during the day
- Agitation
- Acne
- Anger
- Palpitations
- Change in appetite
- Headache: relaxation technique (see below)
- Dizziness
- Nausea/Vomiting
- Constipation
- Bloating
Stress can amplify all these signs and symptoms!
To better understand them and effectively link them to PMS and not something else, Follow the Menstrual Diary tip below.
- Rest and adjust your sleep
- Relaxing and calm activities
- Regular physical exercise: reduces bloating, anxiety, insomnia, constipation and irritability: 30min a day minimum:
See our tips for less painful periods without medication
- Diet: as little modified food as possible, lighter and more frequent meals, less sugar, more protein
- Reduce stress: avoid stressful activities
- Use relaxation techniques: see below + our other tips without medication
- Light therapy
- Avoid consumption of: alcohol, coffee, tea, sodas, chips, processed foods, junk food...
- Increase your intake of : fiber (chickpeas, beans, green vegetables, whole wheat breads and pastas...), calcium-rich foods (chervil, almonds, flaxseed, hazelnut, sardine, walnut, coconut milk, oat milk... ), iron (pulses, cereals, beans, cocoa, sesame lentils, passion fruit, blackcurrant...) and vitamin D (herring, anchovies, olive oil, egg yolk, salmon, cod liver oil...)
Learn even more tips for managing your stress and pain!
3. Heavy Period : Menorrhagia or Hypermenorrhea
Corresponds to heavy and prolonged periods.
- One IMBHIBITED tampon/pad in 1 hour
- 6-7 sanitary protections per day
- 3 days of heavy flow
- Need to wear more than one sanitary protection at a time
- Need to change the protection during the night
- Blood clot: diameter exceeding a 25cent coin or 2cm / 0.78inch
These criteria can be considered as menorrhagia.
Consult a gynecologist FAST!
Different causes :
- Endometriosis: painful period (or dysmenorrhea) and abundant, for more information see our blog: When to worry about period pain?
- Medical devices: such as copper intrauterine devices (IUDs) can cause heavier and/or irregular periods in the first few months of use.
- Sexually Transmitted Infection: can cause some disturbances:
Chlamydia: bleeding outside of menstruation and longer, heavier periods
Gonorrhea: bleeding outside of menstruation, more painful and intense menstruation
Genital herpes: more painful periods
- Coagulation disorder (20% of menorrhagia): the coagulation is defective and can lead to more intense flows, consult quickly for an adapted treatment
- Anovulation: thicker uterine mucous membrane, which leads to a heavier flow (more common in overweight women)
- Premenopause: naturally around 45 years old: abundant flow accompanied by a blood clot
What to do?
Consult a gynecologist as soon as possible and have a blood test done to check for possible clotting disorders or the presence of anemia, endometriosis, an STI or any other detectable disorder.
Testing another contraceptive method, or talking to the man or men about using male contraceptives, can also be a solution to the effects of your contraception.
4. Irregular periods
Sometimes periods can be irregular, no panic at first glance this can be due to many reasons.
You have :
- Bleeding outside of your period = spotting
- Presence of menorrhagia
- Amenorrhea = absence of menstruation
- Menstruation longer than usual
- Variation of more than 5 days from one cycle to another
- Cycle lasting less than 21 days or more than 35 days
The menstrual cycle is regulated by hormones, i.e. by the endocrine function (release of hormones by your body) of your ovaries. This delicate balance can be disrupted by many causes:
Hormonal changes
Puberty: after having your first period, your cycle can be irregular for the next 2 years. If you don't have regulation, this can be caused by: intense stress or rapid weight change (more or less). Consult a gynecologist without delay!
Peri-menopause (transitional phase of menopause): a period of 4-8 years between the ages of 40 and 50 when menstruation can be irregular because the ovaries gradually stop ovulating, making the menstrual cycle quite unpredictable. The flow is also affected: weaker or more abundant than usual. You can have amenorrhea (see below for more details) and then not have a period at all.
Significant weight change
Large and rapid changes in weight, whether lost or gained, can lead to irregular menstrual cycles.
Due to weight gain, estrogen production increases too much, acting on your genitals, causing disturbances in the frequency of menstruation, sometimes even stopping it altogether.
Too much physical activity
Intensive training repeated over a long period of time combined with the presence of very little fat can cause the stressed body to save energy.
Thus the brain will indicate to stop the production of sex hormones, in order to preserve the energy that could be spent in reproduction or menstruation.
Don't worry, after limiting or stopping intensive physical activity, your period will return. However, if this is not the case, CONSULT QUICKLY, it may be due to a different amenorrhea. (See below the section on amenorrhea)
Sleep disorder
By disturbing your sleep, you disturb the fragile balance of your hormones, which can in the long term affect the hormones of reproduction and therefore ovulation and menstruation.
Also affecting melatonin (a hormone with a reproductive role), said to be photosensitive, it needs to be in the dark to be produced. So if you sleep during the day because of a bad sleep rhythm, make sure you sleep in the dark as much as possible. This can affect people with jet lag as well and people who travel a lot.
Endometriosis
Endometriosis is a disease that can cause irregular periods because uterine tissue grows much larger than normal and is deposited outside the uterus.
This creates very heavy flow, irregular cycles and bleeding outside of menstruation.
See the article on endometriosis for more information
Eating disorder
The same situation as for intensive physical activity, a poor diet or eating disorder such as anorexia nervosa or bulimia can lead to a lack of menstruation for reasons of energy conservation. Consult quickly.
Thyroid disorder
The thyroid, this great hormonal regulator, can cause great disturbances in case of dysfunction.
The dysfunctions of the thyroid gland include 2 types:
Hypothyroidism (hypoactive) often presenting as:
- Always being cold
- Irregular cycle
- Puffy face
- Constipation
- Heavy menstrual flow
- Pale skin
- Rapid and abnormal weight gain
- Slow heartbeat = bradycardia (below 60 beats per minute)
- Permanent fatigue
Hyperthyroidism (overactive):
- Irritability
- Swollen eyes
- Diarrhea
- Always being hot
- Unexplained weight loss
- Insomnia
Stress or depression
When stress or depression is present on a daily basis, it can affect the delicate hormonal balance.
Stress releases cortisol in overdose and this can have an effect on ovulation itself. It can stop or delay the onset of menstruation.
Don't get caught up in your anxiety and try as many stress-busting techniques as possible:
- Get as much sleep as you can
- Be physically active for at least 30 minutes a day
- Take time for yourself
- Eat a healthy and varied diet
- Limit your consumption of stimulants: coffee, tea, tobacco or alcohol
- Relaxing food in moderation: chocolate, eggs, avocado, fatty fish,...
- Try meditation for at least 30 minutes a day: start with guided meditations on YouTube for example
Polycystic ovary syndrome
Corresponds to a common hormonal disease that can occur at any time between 15 and 45 years old.
This syndrome is caused by a hormonal imbalance, resulting in longer menstrual cycles, amenorrhea and fertility problems.
You may have the following signs and symptoms :
- Irregular menstruation: warning sign
- Acne
- Alopecia (hair loss)
- Diabetes
- Excessive hair growth
- Significant weight gain
Carry out a blood test, a pelvic examination and an ultrasound in order to evaluate the presence of ovarian hypertrophy with more or less presence of ovarian cysts.
Often, by improving lifestyle habits, a significant improvement can be observed.
5. Dysmenorrhea
Dysmenorrhea is pain during or outside of menstruation: usually 1-3 days before.
- Peak pain: often 24 hours after the beginning of the period
- Relief: 2-3 days after the beginning
- Form: Cramps, pulsatile, dull or constant
- Radiation: legs, lumbar and back
- Premenstrual syndrome: during or part of the period
There are two types of dysmenorrhea:
Primary dysmenorrhea (more common)
This is not due to gynecological structural pathologies. The resulting pain is related to uterine contractions and ischemia (insufficient blood supply or related to local anemia).
Secondary dysmenorrhea (due to pelvic anomalies)
Visit our site entirely dedicated to the relief of menstrual pain!
6. Amenorrhea or absence of menstruation
2 types :
- Essential: total absence of menstruation
- Secondary: occur and disappear
Amenorrhea can be due to several factors:
- Before puberty: before the growth of the reproductive organs is completed there will be no menstruation and this is quite normal
- During a pregnancy: following fertilization, the endometrium remains in place and plays an important role in the growth of the embryo
- During breastfeeding : notably due to prolactin (hormone responsible for lactation) which inhibits (= stops) the menstrual cycle
- After the menopause: at this time, menstruation stops around
- Contraception: some hormonal contraceptives can prevent menstruation
Apart from these 5 situations, amenorrhea can be linked to a serious disorder, consult without delay!
The most common ones are :
- Dysfunction of the hypothalamus (structure located in the brain responsible for many functions)
- Dysfunction of the pituitary gland: damaged or with too high a prolactin level
- Thyroid dysfunction: hypothyroidism (hypoactive) or hyperthyroidism (overactive)
- Polycystic ovary syndrome
- Premature menopause
- Medications: antidepressant or antipsychotic
- Major depression
- Obsessive-compulsive disorder
- Chronic stress
- Radiation therapy or injury
- Intense physical activity: high level athlete
- Eating Disorder or heavy weight loss: during a bad diet, the body stops the elements that are too demanding in energy to concentrate on the vital organs
When to consult for amenorrhea?
When in doubt, take a pregnancy test because this is one of the most common reasons for a woman of childbearing age.
Looks like essential (or primary) amenorrhea when present:
- No signs of puberty before age 13: growth spurt, breast development
- Signs of puberty present but no menstruation before age 15
Resembles secondary amenorrhea when present:
- Less than 9 periods per year
- No menstruation for 3 cycles
- Sudden change in menstrual pattern
7. Menstrual Cycle Diary
Keep a diary of symptoms during the cycle to better understand them and your body. See arriving the signs and symptoms before menstruation. During menstruation also note the amount of blood. This way, you can act on any unusual changes and consult a doctor more quickly for better prevention!
It will help you better understand how YOUR body works, how you react to hormones and how to deal with your period in a more serene way.
Write down as much information as possible:
- Dates and length of your period
- Length of your cycle: number of days between the first days of your period
- Intensity of flow each day: light, medium, heavy
- Signs and symptoms observed throughout the cycle: allows you to recognize your menstrual precursors and therefore to better prepare yourself for their arrival: headache, back pain, bleeding outside of menstruation, diarrhea, constipation, stomach ache, chest pain, oily skin ....
- Hygienic protection (pads, unbleached tampons, etc.) or methods used (e.g. intuitive flow)
- Quality of sleep: insomnia, good night, several awakenings...; of food (craving for sugar, salt, junk food...), of sport: intense, average, low
- Weight variation
- Sexual relations in the cycle: absence, protected or not
- Libido: high, average, low
- Mood: positive, mood swings, rather neutral, cheerful, excited...
: Day of menstruation
For this you only need a diary or a calendar, you can also use the many applications dedicated to these observations.
- According to the Analysis of Sexual Behavior of Youth (ACSJ) conducted by the National Agency for Research on AIDS (ANRS), 1994
- Dossus et coll. Latitude and ultraviolet radiation dose in the birthplace in relation to menarcheal age in a large cohort of French women. Int J Epidemiol, avril 2013, Vol. 42, pp. 590–600.