A healthy menstrual cycle does not have to be a perfect 28 days, just as your bleed every cycle does not need to be a set number of days. So, what does a healthy menstrual cycle look like?
There is a huge variation in normal which varies from woman to woman, and all comes down to age, lifestyle factors and general overall health. Normal is what is normal for YOU.
What is important to know is to be in tune with your cycle or at least have some understanding of your menstrual cycle, so that if variations occur, you can be aware of the changes and look to investigate further if you suspect something is not quite right.
What is a normal menstrual cycle?
When we first menstruate during puberty, our cycle length can be all over the show, from 23 days up to 90 days apart. It can take some time for our cycles to become more ‘regular’ and predictable. During our late teens to late 30’s, typically our menstrual cycles are anywhere between 24 days to 36 days – but again, can vary. What we do know with menstrual cycles and our health is that during times of stress, over exercising and under eating, our periods can be put on ‘pause’. Following childbirth our cycles can vary, and likewise, when we creep into our early to mid 40’s (roughly) we begin to enter another phase – peri-menopause: where our cycles typically shorten over time. It is also normal for your cycle to vary and change from month to month…..but, what is considered ‘not normal’ is a CHANGE or several changes that don’t settle. For example, mid cycle spotting, bleeding or discomfort during intercourse, cycle lengths that shorten with new heavier bleeding or cycle lengths that lengthen with new heavier bleeding, cycles that come with marked emotional changes, such as anxiety, feelings of anger or rage, tearfulness or new physical complaints such as sore breasts, painful cramps, headaches/migraines and insomnia. These are some and not all suggestions that may warrant you to investigate your health further.
Bleeding should typically be between three and seven days in length, with the heaviest flow on day two (but can vary). Normal blood loss is anywhere between 30 to 80mls over a course of a period (Romm, 2021). Using no more than six pads or tampons a day is a normal amount of bleeding (Romm, 2021). A bleed or period is considered heavy when it lasts 8 or more days, you are soaking through pads and or tampons regularly, you have to change pads throughout the night or you experience large blood clots, experience fatigue or suffer from anaemia due to frequent blood loss (Romm, 2021). Although with the introduction of menstrual cups and period underwear, how can we know for sure what our flow is like, and are we checking?
The four stages of a menstrual cycle:
Menstruation:
Days 1-6 of your cycle. Day 1 is considered the FIRST day of your new cycle. This is the time when your endometrial lining is shed (bleeding). The hormones estrogen and progesterone are at their lowest at this time in your cycle, although estrogen begins to slowly rise. Tiredness and the desire for rest rather than exercise is common through at this time (but you should not be feeling so fatigued that it interferes with your everyday life).
Follicular phase (proliferative phase):
Days -13 of your cycle (including menstruation). The uterine lining is beginning to proliferate or build (hence the name proliferative phase), follicles are ripening inside the ovary in preparation for ovulation and glands in the cervix begin the production of cervical mucus. Following your bleed, your cervical mucus is either dry or damp, white in appearance and feels pasty or crumbly. As you approach ovulation, your cervical mucus changes in appearance and texture to clear, stringy, slippery and even egg white. This is fertile cervical mucus which helps sperm to survive until ovulation has occurred. Therefore, conception can occur 5-7 days before ovulation – your cervical mucus nourishes the sperm! Estrogen rises, follicle stimulating hormone (FSH) rises (peaks at ovulation) and testosterone increases. This is also a time of good energy, motivation and a good time to get new projects started or finished!
Ovulation:
Days 14-18 one egg (sometimes two) is released from the ovary. Estrogen peaks stimulating the luteinising hormone (LH) to surge. The egg is released when the dominant ovarian follicle ruptures. No surprises that this is a time in your cycle where you feel the most ‘tuned in/switched on’ and very keen…if you know what I mean!
Luteal phase (Secretory phase):
Days 14-18 (includes ovulation) – From ovulation to the start of your next period. This is the phase where if pregnancy does not occur, your body prepares for menstruation and if you do conceive, your body is preparing to implant the potential pregnancy into the uterus. Progesterone is produced and dominates the luteal phase. After the mid-luteal phase, if conception did not occur levels of progesterone and estrogen drop causing the endometrium to shed, and with this, your next cycle begins. If you did conceive, the body continues to produce progesterone (from the corpus luteum) to support the pregnancy until the placenta takes over (between 10-12 weeks).
Trying to conceive?
Using an app is handy – But observing your cervical mucus is even better! After your period ceases, start to observe your cervical mucus several times per day. When you are not yet fertile, you will produce very little mucus or a little which is creamy or white. The texture can feel flaky or crumbly to the touch. As you head towards mid cycle or ovulation, your cervical mucus changes and becomes more wet, clear or stringy (egg white). After ovulation, your cervical mucus changes back to less fertile again – the white/pasty/crumbly and you produce less of it.
How to check? Use 2 clean fingers and touch the entrance of your vagina to observe what you see. It is as easy as that! Notice how it may change throughout the day.
Changes in the cervix: Following your period, use 2 clean fingers and insert high into the vagina to feel your cervix. When you are not fertile your cervix will feel like the tip of your nose (firm). When you are heading towards ovulation or mid cycle, your cervix will feel soft (like your bottom lip). During ovulation, you may not be able to feel it at all. Following ovulation and when you are no longer fertile, your cervix will feel firm like the tip of your nose again. Clever! Please note when you do check your cervix it only needs to be once per day, at the same time, and not after a bowel movement or intercourse. Easy! See more here: https://www.bespokebirths.co.nz/natural-fertility
Avoiding conception?
Just as for trying to conceive - you would avoid intercourse during your fertile times instead. Best taught by an accredited fertility educator and in conjunction with taking your basal body temperature daily, you have what is known as the Sympto-thermal method – 98% effective when taught by a qualified teacher (and of course used as taught!). See more here: https://www.bespokebirths.co.nz/natural-fertility
When our cycle goes AWOL or is unpredictable, troublesome or causing concern?
Always start with your GP/Gynaecologist to rule out anything serious. A registered Naturopath, Homeopath or acupuncturist are great places to start. They will take a full case history and look at your overall health – rather than one thing in isolation. Supplements, herbs, vitamins/minerals may be prescribed and will be to meet your own individual needs – hence, why seeking help from a professional is always better than taking tons of different supplements from over the counter.
Seeing changes takes time and commitment – so stick it out as the improvements are worth it.
Wishing you healthy and happy menstrual cycles for years to come….!
References
Romm, A. (2021). Hormone Intelligence: The complete guide to calming hormone chaos and restoring your body’s natural blueprint for well-being. Harper Collins.