Menstrual Cycles - What's Normal?
Art by Alex Neonakis - @alexneonakis on Instagram
We don’t talk about them very openly in day-to-day life so there are huge misconceptions as to what is normal!
One of the most important things to know is that your cycle on the pill is not a menstrual cycle. A pill cycle is a withdrawal bleed - bleeding as a result in the drop of hormones during the placebo week of the birth control cycle. It really doesn’t tell us a lot about what’s going on underneath the hormone dose you’re getting!
In terms of your actual menstrual cycle. This is what we are looking for!
Bleeding: 3-7 days long
Blood: Mostly liquid, a few clots are okay, but they shouldn’t be larger than 1-2cm
Volume: 25-80mL total (a regular tampon holds 5mL, a regular pad holds 5mL, a super pad - 10mL, a Divacup holds a total 30mL). If you’re bleeding more than this you need to get your iron level checked ASAP!
Discomfort: Mild abdominal discomfort is normal, but it shouldn’t interfere with your daily activities. The pain should be easily relieved by painkillers, and shouldn't require painkillers throughout.
21-35 days from Day 1 of bleeding to Day 1 of bleeding the next cycle. It's okay if it's not the same length every month as long as it's in this range and all of the other signs are pointing to healthy menstruation.
Ovulation near the middle of the cycle. The only way to definitely know that you’ve ovulated is to check blood progesterone later in the cycle, but there are other signs and symptoms that can indicate ovulation such as stretchy cervical fluid and a slight increase in temperature. Some people do experience ovulatory pain, but it should be momentary! PSA: Your app does NOT know when you ovulate it’s guessing by counting cycle dates. If we’re trying to target ovulation (i.e. you’re trying to get pregnant) we need to dive into looking at these other details more closely
Menstruation should occur again 12-16 days after ovulation. In people with shorter cycles we want to make sure there are at least 12 days after ovulation and before menstruation
Premenstrual symptoms are common, but not inevitable. There are things we can do to change the irritability, depression, cravings, bloating, breast tenderness, sadness, or anxiety. You don’t need to suffer!
Understanding your cycle is so key to understanding your health. It’s a great monthly check-in. If you think something is off - reach out!