Your period-what’s normal, what’s not

Abnormal menstrual bleeding is one of the most common problems that brings women to their physician. But what exactly is “normal”? When should you worry about your periods?

According to American Family Physician journal (Volume 99, Number 7)

“abnormal uterine bleeding falls outside population-based 5th to 95th percentile for menstrual regularity, frequency, duration, and volume.”

Or, you could say -“normal” is that periods vary widely for most women

How doctors talk about normal

Doctors sometimes use medical terms to describe abnormal bleeding-menorrhagia, metrorrhagia, even meno-metrorrhagia, which are imprecise and often misunderstood. In 2011 FIGO, the International Federation of Gynecology and Obstetrics developed standard definitions and descriptions of menstrual bleeding, also endorsed by the American College of Obstetricians and Gynecologists.

This post will outline the FIGO definitions. Anytime you are concerned about your bleeding you should talk to your doctor. This information may help you describe your concerns to your doctor and understand what is “normal” for you.

The frequency, regularity, duration, and volume of a period are all important to determine if they are normal.

What is Your Menstrual Cycle?

The Menstrual cycle is the length of time from the first day of a period until the next one starts; in other words, from day 1 to day minus 1. You can also think of this as the frequency-how often you have a period. Every 24 to 38 days is considered normal.

  • Infrequent->38 days
  • Normal 24-38 days
  • Frequent <24 days

The regularity of the menstrual cycle is how much the length varies over time, usually 12 months. Is it always 24 days, 28, 32? Or does it vary, sometimes 24, or sometimes 38? Either can be normal, but if your pattern suddenly changes, it may indicate something has happened.

  • Regular cycles vary by 2-20 days over 12 months
  • Irregular- cycles vary >20 days over 12 months

What is your menstrual period?

The duration or length of your menstrual period is how many days you bleed, no matter how much or how little. Again, what’s important is your usual pattern; for most women this stays consistent, so a change is usually noticed.

  • Short <4.5 days
  • Normal 4.5-8 days
  • Prolonged >8 days

How heavy is your period?

The amount, or volume of a period is how much blood you lose. From 5-80 ml , or for Americans 1 teaspoon to 3 ounces, is considered normal although most of us find counting pads or tampons per day is easier to understand.

  • Light <5 ml
  • Normal 5-80 ml
  • Heavy >80 ml

Amenorrhea means no bleeding for 90 or more days. Once a woman has not had bleeding for 12 months, this is menopause. (This does not apply if she stops bleeding because her uterus is removed, a hysterectomy. Menopause is defined differently in that case. )

What can change the cycle length or regularity, or the period length, duration, or amount of bleeding?

  • Using some form of hormonal birth control
  • Recent pregnancy
  • Breast feeding
  • Vigorous or intense physical activity
  • Serious illness, injury, or surgery
  • Starvation
  • Peri-menopause (the months prior to menopause)

If you doctor determines that your bleeding is “abnormal” she may evaluate you for the common causes-

  • complications of pregnancy-miscarriage, ectopic pregnancy
  • uterine fibroid tumors-leimyomata
  • cervical or uterine cancer
  • bleeding disorders
  • hormone dysfunction, including PCOS (polycystic ovarian syndrome)

Where to learn more about menstruation

Familydoctor.org offers this easy to understand outline of the causes and treatment of abnormal bleeding.

Abnormal uterine bleeding

Información en español – from the CDC

Sangrado menstrual abundante

Most cases of abnormal bleeding have a straight forward cause which can be determined by the history, examination, and appropriate testing. Most are treatable and not life threatening. However, since a few cases will be due to cancer, don’t ignore this important symptom.

Keeping track of your periods

You can use any blank paper or digital calendar to keep track of your periods but digital apps are a convenient way to keep track of your periods.

Flo Period & Ovulation Tracker

Flo Period Tracker, Ovulation & Fertility Calendar!

It’s a smart and simple female period tracker, helpful pregnancy week by week app, accurate ovulation and fertility calendar and PMS symptoms tracker for women all over the world. Flo Period Tracker not only tracks your period accurately, but it’s also a reliable pregnancy calculator, ovulation calendar, and true fertility friend for you. It’s the first period app, pregnancy calculator, fertility and ovulation calendar for women that uses machine learning (AI). All women, even those with irregular periods, can rely on this health tracker. Log your menstruation days in a handy period calendar, ovulation and fertility tracker, schedule menstrual cycle reminders, record moods and PMS symptoms, use a due date calculator, follow a pregnancy calendar and take full control of your health.

However you do it, take your menstrual record with you every time you visit your doctor.

photo from LIGHTSTOCK.COM, an affiliate link

sharing the HEART of health

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

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                              Dr. Aletha 

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May timely topics-memories, memorials, and mothers

May is a month of celebrations and remembrances.

You’ll find several affiliate links in this post, to help me fund this blog and give extra value to you, my readers.

In the United States, we call the second Sunday in May Mothers’ Day to honor mothers. We may not be one, but we all have one, although like me, yours may be deceased.

You may have pleasant or not so pleasant memories of your mother, as nurturing may not come easily to some women, possibly because they did not receive it. Sometimes when that happens, other women step in to bridge the gap. They deserve to be honored also.

Other events that typically occur in May include proms, graduations, and weddings. I know because I married my husband in May; I almost share an anniversary with the Duchess of Sussex, the former American actress Meghan Markle. And now she and Prince Harry are new parents of a so cute baby boy, Archie. What a sweet family they make.

May timely topics include

  • parenting issues
  • spring and summer health concerns
  • Memorial Day, another U.S. national observance
  • women’s’ health
  • books about mothers

thanks for exploring with me

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

To start following Watercress Words , use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn, links are on the left side bar here and the Home page. Thanks so much.

You will find links to the Timely Topics on the Home page and on the right sidebar on every post (you may need to scroll down to find them on a mobile or tablet)

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cheesy-free faith-focused stock photos

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                              Dr. Aletha 

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