With so much variation in how many women experience their monthly cycle, it’s difficult for a woman to know what is ‘normal’ and what they should flag with the doctor.
So to help answer some common questions, FEMAIL spoke to Australian general practitioner and owner of Sapphire Family Medical Practice in Bondi Junction, Dr Dasha Fielder.
‘The most important point to make is that women’s menstruation cycles can vary significantly, which is completely normal,’ she said.
‘There is a lot of inaccurate information provided by alternative health practitioners that creates anxiety in women and results in unnecessary tests and treatments that have no evidence behind them.’
There is still a lot of mystery surrounding what is considered normal when it comes to periods so Dr Dasha Fielder discussed every aspect of periods you need to know
Cycle length may vary from person to person
Dr Fielder said that a normal cycle is anywhere between 26 to 35 days with a period that lasts from three to seven days.
Periods normally start with brown discharge and mild cramps and proceed to heavier bleeding for two to three days with stronger cramps.
Then after this the blood becomes lighter before eventually concluding.
‘How women respond to hormonal fluctuations and pain is greatly variable but not in itself abnormal,’ she said.
Oestrogen can result in insomnia and progesterone can make you bloated
Oestrogen is the primary female sex hormone that is responsible for the development and regulation of the female reproductive system, which Dr Fielder said peaks mid cycle.
Then as the days go on progesterone, another sex hormone involved in the menstrual cycle, begins to rise and oestrogen begins to drop.
‘In general some women can respond to dropping oestrogen with negative side effects such as mood variations, anger and insomnia,’ she said.
‘Progesterone rising can make some women bloated, constipated and prone to water retention.
‘However it is important to note that this is completely normal and should not be presented to women as something that needs changing and investigating.’
Dr Fielder said oestrogen and progesterone are important hormones for women that controls their reproductive cycle and their main function is to assist with reproduction and pregnancy.
Oestrogen is the primary female sex hormone that is responsible for the development and regulation of the female reproductive system, which Dr Fielder (pictured) said peaks mid cycle
What is Polycystic ovary syndrome?
Polycystic ovary syndrome (PCOS) is a condition that affects a woman’s hormone levels.
Women with PCOS produce higher-than-normal amounts of male hormones.
This hormone imbalance causes them to skip menstrual periods and makes it harder for them to get pregnant.
Source: Health Line
Testosterone has an effect on your libido and health
Testosterone is another hormone that plays a part in women’s menstrual cycle and it is produced in both men and women, although it is less significant in women.
Relatively small quantities of testosterone are released into your bloodstream by the ovaries and adrenal glands.
The hormone is part of what drives desire and thoughts about sex, and even helps provide the energy for sex in women.
Women’s testosterone levels gradually go down as they age, and lower amounts of the hormone can lower muscle mass, affect skeletal health, and decrease sensitivity in the vagina and clitoris.
‘Although the libido is multifactorial in women and influenced by many things, testosterone is one of the many things that has been linked to the libido,’ she said.
‘When testosterone levels are too high common conditions such as polycystic ovary syndrome (PCOS) may occur or primary adrenal hyperplasia, which is a rare condition that results in hormonal imbalance may appear,’ she said.
‘These are complex conditions and women should seek medical help.’
‘Testosterone has been linked to the libido although the libido is multifactorial in women and influenced by many things, with testosterone being only one of them,’ she said
The unusual signs to look out for
Dr Fielder said there are a variety of signs women should pay attention to that may indicate they need professional help.
‘If your cycle is longer then 35 days, if you are experiencing excessive hair growth, voice change or your cycle is prolonged and heavy or you have intermenstrual bleeding, it is worthwhile to discuss this with your doctor,’ she said.
‘And looking at your history and an examination it might be appropriate for your doctor to run some basic tests.’
‘However hormones vary from day to day and even from time of the day which means measuring oestrogen, progesterone and testosterone in women is not always.’
Dr Fielder said her main point is that periods vary and hormones change throughout the cycle.
She said women shouldn’t focus too much on their cycle and focus on managing their symptoms with a healthy diet, regular exercise, good sleep, maintaining a healthy BMI and reducing alcohol consumption.
What does it mean when your period is ‘heavy’?
There are some conditions of the womb and ovaries that can cause excessive bleeding so, if you’re worried about your bleeding, your periods have become heavier or you also having other symptoms, like period pain or bleeding between your periods, it’s worth going to see your GP.
Conditions that could affect your flow include:
· Uterine fibroids. Most common during childbearing years, these are non-cancerous growths of the uterus. They can range in size and you could have one or many. The interesting thing is that many women do have them but don’t know it, because they don’t cause any symptoms.
· A hormonal imbalance. Your hormones do a lot for your body and sometimes they can get a little out of whack. Having a hormone imbalance could be due to a number of things, including Polycystic Ovary Syndrome (PCOS) and endometriosis. The signs are plenty, including insomnia, irritability, weight gain, a low libido, depression and fatigue. All of these things can contribute to having a heavier than normal flow.
· Miscarriage. Losing the fetus before the 20th week is called a miscarriage. Not only can the toll it takes on your body cause heavy periods, but the stress that comes with it can too.
· Ectopic pregnancy. Normally, when the ovaries release an egg and it becomes fertilied by sperm in the fallopian tubes, it travels into the uterus. Sometimes, in up to 1 out of 50 pregnancies, the egg stays in the fallopian tubes. This is called an ectopic pregnancy and can be the cause of heavy periods.
· Adenomyosis. Considered a benign condition Adenomyosis happens when the inner lining of the uterus breaks through the muscle wall of the uterus. Despite being non-threatening, this condition can make for painful cramps and heavy bleeding.
· Pelvic Inflammatory Disease (PID). About 1 million women each year are affected by PID. It happens when the cervix is exposed to disease-causing organisms. The most common cause is Sexually Transmitted Infections but abortions, childbirth and other pelvic procedures can also cause it. Depending on what your doctor finds, they may prescribe some type of contraceptive, medicines or even recommend surgery.