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.

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.

                              Dr. Aletha 

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Most viewed post #3- To Joey, With Love- a movie review

I’m pleased this post was so popular because it is such a touching story of love and commitment, something we need to hear more about. My thanks to Rory Feek for continuing to share his journey with his words and his music.

To Joey, With Love

A Story of Life, Love, and Hope That Never Dies

90 minutes , with Spanish and English subtitles for the hearing impaired

Provident Films 2016

(affiliate links used in this post)

To Joey, with Love is the intimate, authentic, and transparent story of a couple who met head on two of life’s most difficult challenges- a special needs child and a terminal illness. Rory produced the film because he believed their story needed to be remembered, documented and shared.

To Joey, With Love- A Story of LIfe, Love and Hope That Never Dies

To Joey, With Love- A Story of LIfe, Love and Hope That Never Dies The story of Joey and Rory Feek

Joey and Rory Feek had a successful career as a country music singing duo and a happy 12 year marriage when they decided to take a year off to have a baby. For many years Joey had been afraid to have a baby,fearing she would not be a good mother.

Her pregnancy progressed normally and culminated in a planned at home birth attended by a midwife.Sudden complications forced a trip to a hospital where both mother and baby were stabilized and in no immediate danger.

Unfortunately, the doctors and nurses told Joey and Rory that their much anticipated child had a problem- their new baby girl had Trisomy 21, also known as Down syndrome.

Indie’s challenge- Down Syndrome

People with Down syndrome have an increased risk for certain medical conditions-

  • congenital heart defects,
  • respiratory and hearing problems,
  • Alzheimer’s disease,
  • childhood leukemia and
  • thyroid conditions.

Many of these conditions are now treatable, so most people with Down syndrome lead healthy lives.

Here are more  Down Syndrome Facts

Trisomy 21 chromosomes

Children with Down Syndrome have an extra chromosome, number 21 (see arrow) Diagram courtesy of Dr. Clark Heath of the CDC

Joey’s challenge-Cervical cancer

A few months after their baby Indiana’s birth, Joey  faced the recurrence of cervical cancer diagnosed and treated years before. Despite more surgery, radiation and chemo the cancer persisted until further treatments were futile and and likely to cause more suffering. Joey decided to leave their Nashville farm,her horses, chickens and gardens, to move home to Indiana to spend her remaining time with her extended family.

Faced with the persistence of the cancer

“Joey decided to come home-not to die, but to live.”

Cervical cancer is cancer that starts in the cervix, the narrow opening into the uterus from the vagina. More than 12,000 women in the United States will be diagnosed with cervical cancer each year, and more than 4,000 of women will die.

Cervical cancer is the second most common type of cancer for women worldwide, but because it develops over time, it is also one of the most preventable types of cancer since the widespread use of the Pap test to detect cervical abnormalities leads to early treatment.

Cancer of the cervix tends to occur during midlife. Half of the women diagnosed with the disease are between 35 and 55 years of age. It rarely affects women under age 20, and approximately 20 percent of diagnoses are women older than 65. Women should ask their doctor how often and for how long they should continue having Pap smears.

The National Cervical Cancer Coalition provides this overview of cervical cancer treatment. overview of cervical cancer treatment

Get the Inside Knowledge about gynecologic cancer.

In 2014 Rory Feek started sharing their lives in a blog and on Facebook which is where I first learned about them. In his “About” ,  Rory writes

“My name is Rory. I want to live a great story. I want to be a better man. I film. I write. I show up. God does the rest…”

Rory kept writing. Eventually, he shared the entire story on the blog, which also lead to his book by the same name, and eventually the movie.

This LIfe I LIve by Rory Feek

This LIfe I Live One man’s extraordinary, ordinary life and THE WOMAN WHO CHANGED IT FOREVER

This Life I Live: One Man’s Extraordinary, Ordinary Life, and the Woman Who Changed It Forever 

“In This Life I Live, Rory Feek helps us not only to connect more fully to his and Joey’s story but also to our own journeys. He shows what can happen when we are fully open in life’s key moments, whether when meeting our life companion or tackling an unexpected tragedy. He also gives never-before-revealed details on their life together and what he calls “the long goodbye,” the blessing of being able to know that life is going to end and taking advantage of it. Rory shows how we are all actually there already and how we can learn to live that way every day.” (Amazon review)

Here is a link to a book excerpt-

RORY FEEK OPENS UP ABOUT HOW HE MET AND

FELL IN LOVE WITH HIS LATE WIFE, JOEY

And now as a single dad, raising their daughter Indie alone, Rory continues to blog at This Life I Live.

Although I cried throughout ,  I’m glad I watched To Joey, With Love, and recommend it to you, as well as Rory’s book. Follow him at his blog and on Facebook.

 

Movie, book, and music also available at
Barnes & Noble – Free Shipping of $25+

 

Please share with your friends and join me  for the year’s 2nd  most viewed post

Follow Watercress Words as we explore the HEART of HEALTH. 

 

Thanks for your time and interest.

Dr. Aletha 

To Joey, With Love- a movie review

To Joey, With Love

A Story of Life, Love, and Hope That Never Dies

90 minutes , with Spanish and English subtitles for the hearing impaired

Provident Films 2016

(affiliate links used in this post)

To Joey, with Love is the intimate, authentic, and transparent story of a couple who met head on two of life’s most difficult challenges- a special needs child and a terminal illness. Rory produced the film because he believed their story needed to be remembered, documented and shared.

To Joey, With Love- A Story of LIfe, Love and Hope That Never Dies

To Joey, With Love- A Story of LIfe, Love and Hope That Never Dies The story of Joey and Rory Feek

Joey and Rory Feek had a successful career as a country music singing duo and a happy 12 year marriage when they decided to take a year off to have a baby. For many years Joey had been afraid to have a baby,fearing she would not be a good mother.

Her pregnancy progressed normally and culminated in a planned at home birth attended by a midwife.Sudden complications forced a trip to a hospital where both mother and baby were stabilized and in no immediate danger.

Unfortunately, the doctors and nurses told Joey and Rory that their much anticipated child had a problem- their new baby girl had Trisomy 21, also known as Down syndrome.

Indie’s challenge- Down Syndrome

People with Down syndrome have an increased risk for certain medical conditions-

  • congenital heart defects,
  • respiratory and hearing problems,
  • Alzheimer’s disease,
  • childhood leukemia and
  • thyroid conditions.

Many of these conditions are now treatable, so most people with Down syndrome lead healthy lives.

Here are more  Down Syndrome Facts

Trisomy 21 chromosomes

Children with Down Syndrome have an extra chromosome, number 21 (see arrow) Diagram courtesy of Dr. Clark Heath of the CDC

Joey’s challenge-Cervical cancer

A few months after their baby Indiana’s birth, Joey  faced the recurrence of cervical cancer diagnosed and treated years before. Despite more surgery, radiation and chemo the cancer persisted until further treatments were futile and and likely to cause more suffering. Joey decided to leave their Nashville farm,her horses, chickens and gardens, to move home to Indiana to spend her remaining time with her extended family.

Faced with the persistence of the cancer

“Joey decided to come home-not to die, but to live.”

Cervical cancer is cancer that starts in the cervix, the narrow opening into the uterus from the vagina. More than 12,000 women in the United States will be diagnosed with cervical cancer each year, and more than 4,000 of women will die.

Cervical cancer is the second most common type of cancer for women worldwide, but because it develops over time, it is also one of the most preventable types of cancer since the widespread use of the Pap test to detect cervical abnormalities leads to early treatment.

Cancer of the cervix tends to occur during midlife. Half of the women diagnosed with the disease are between 35 and 55 years of age. It rarely affects women under age 20, and approximately 20 percent of diagnoses are women older than 65. Women should ask their doctor how often and for how long they should continue having Pap smears.

The National Cervical Cancer Coalition provides this overview of cervical cancer treatment. overview of cervical cancer treatment

Get the Inside Knowledge about gynecologic cancer.

In 2014 Rory Feek started sharing their lives in a blog and on Facebook which is where I first learned about them. In his “About” ,  Rory writes

“My name is Rory. I want to live a great story. I want to be a better man. I film. I write. I show up. God does the rest…”

Rory kept writing. Eventually, he shared the entire story on the blog, which also lead to his book by the same name, and eventually the movie.

This LIfe I LIve by Rory Feek

This LIfe I Live One man’s extraordinary, ordinary life and THE WOMAN WHO CHANGED IT FOREVER

This Life I Live: One Man’s Extraordinary, Ordinary Life, and the Woman Who Changed It Forever 

“In This Life I Live, Rory Feek helps us not only to connect more fully to his and Joey’s story but also to our own journeys. He shows what can happen when we are fully open in life’s key moments, whether when meeting our life companion or tackling an unexpected tragedy. He also gives never-before-revealed details on their life together and what he calls “the long goodbye,” the blessing of being able to know that life is going to end and taking advantage of it. Rory shows how we are all actually there already and how we can learn to live that way every day.” (Amazon review)

Here is a link to a book excerpt-

RORY FEEK OPENS UP ABOUT HOW HE MET AND

FELL IN LOVE WITH HIS LATE WIFE, JOEY

And now as a single dad, raising their daughter Indie alone, Rory continues to blog at This Life I Live.

Although I cried throughout ,  I’m glad I watched To Joey, With Love, and recommend it to you, as well as Rory’s book. Follow him at his blog and on Facebook.

Movie, book, and music also available at

Barnes & Noble – Free Shipping of $25+