What are (menstrual) periods?
Periods are a normal part of the menstrual cycle. During the cycle, reproductive hormones cause the lining of the uterus, or endometrium, to thicken preparing it for implantation of a fertilised egg. If a pregnancy does not occur, the hormones sustaining the lining of the uterus lower, the endometrium is shed. This is experienced as bleeding each month.
What are ‘normal’ periods?
There is no real ‘normal’ period due to the huge differences between individuals & even between cycles in one individual over their life time. However, there are some clear atypical features that would warrant a talk with your GP:
Individuals have very different cycle lengths & may not have a regular cycle length & this can be very normal. Irregular cycles are particularly common at the start & end of menstrual life. Cycles less than 21 days or more than 35 days may suggest polycystic ovarian syndrome. No periods can suggest pregnancy, menopause or abnormalities in several different hormone systems.
Normal menstrual losses per period range from 5 to 80ml. This can be hard to estimate unless using a menstrual cup. A tampon may hold from 3ml (light) to 12 ml (super) & a pad 5-15 ml, when fully soaked. If you are repeatedly soaking through a tampon/ pad every 2 hrs, this is considered heavy menstrual bleeding & is a common cause of iron deficiency & anaemia. There are many treatment options for heavy, or otherwise bothersome, menstrual bleeding.
There is a big range in the experience of pain with periods & how someone experiences pain is very personal. However, no one should ‘suffer’ from their periods & no one should be told to ‘just put up with them’. Severe period pain such that you miss work frequently, or pelvic pain with weeing or pooing during your period or deep pain during intercourse or pain between your periods is not normal & may suggest endometriosis. There are many options for treating painful periods.
Clots/ colour of the blood:
Menstrual blood is normally broken down by enzymes that prevent clotting to allow it to flow. However, when there is more blood all the enzymes are used up & clots can form. The colour of menstrual blood can range from light pink, to bright red, dark red or brown & any shade in between. This is all completely normal & may vary between cycles.
If you have any concerns about your period talk to your GP.
Do I have to have my periods?
No. There is nothing particularly ‘natural’ about having a period each month. If you are not on hormonal contraception or other medications that may affect your periods then it is NOT normal to have no period & you should see your doctor. However, using hormonal contraception such as the pill, depo-injection or intrauterine devices to reduce or stop your periods is very safe. Surgical options are available for certain situations. In summary, there is no ‘normal’ period but if any thing about your periods is bothering you, including simply having them, have a talk to your GP.
Jean Hailes - www.jeanhailes.org.au
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