Your menstrual cycle – what’s healthy and what’s not?
No two menstrual cycles are the same, however, there are some general principles to keep in mind
If you’ve spoken to a girlfriend, sister or mother about menstrual cycles, you’ll probably have realised that no two cycles are the same. There are, however, some general characteristics of a healthy menstrual cycle to keep in mind, so that you know what changes are normal and whether you need to seek the advice of a healthcare professional.
What does a healthy menstrual cycle look like?
So how long is a menstrual cycle?
“It’s counted from the first day of one period (when bleeding starts) to the first day of the next period, and it isn't the same for every woman,” explains GP Dr Leigh Exelby, who specialises in women’s health.
The menstrual cycle is usually between 21 and 35 days. “For the first few years after menstruation begins, longer cycles are more common,” she says.
“Yet the cycle often changes across a woman's lifetime,” Leigh notes. These changes can happen after pregnancy and as a woman gets closer to menopause, which is when she has her last period.
Duration and flow
The menstrual flow – or bleeding – usually lasts four to six days, Leigh notes.
Again, the length and amount of flow can change over time. “We also tend to see women having periods that become heavier than previously as they enter their 30s and 40s.”
Generally, bleeding can vary from one cycle to the next. Blood colour can vary from dark brown (usually at the start of the flow) to bright red in the peak of the cycle, and then dark brown again towards the end. Most women lose less than 80ml of blood – that’s about one-third of a cup.
Discomfort and pain
Pain is very common during a period, with one study finding that 92% of young Aussie women experienced pain during their cycle. However, if you experience pain that’s anything other than mild, or pain that feels unusual, it’s important to seek medical advice.
And while some women experience pain from the start of menstruating, others develop more painful periods over the years, Leigh notes.
So, what can help?
“If you have period pain that is mild, using paracetamol and heat packs are often enough to keep the pain at bay. Naprogesic and Ponstan are other great options for period pain relief, and you should discuss this with your GP, ” Leigh says.
When to see a medical professional
Leigh says that some women experience severe debilitating pain that prevents them from doing their day-to-day activities or going to work or school.
“This is more unusual,” she says, “and it is worthwhile seeing a GP to identify potential causes of this pain, and to discuss ways to manage and treat it.”
Signs that something is ‘off’ with your cycle
There are some signs that can indicate your cycle may not be normal and are worth checking in with your doctor about, Leigh says. They include when:
you have debilitating period pain that impacts on your life
your menstrual cycle is shorter than 21 days or longer than 35 days
your period lasts for longer than seven days
you have spotting between your period
you tend to have significant clotting or flooding of clothes or sheets
you have pain or bleeding with sexual activity.
“Your GP might assess you by taking a blood sample, swabs or imaging, and help with medication options,” Leigh says. “They may also refer you to a gynaecologist.”
What can be done to help
It might help if you monitor and record your symptoms in a diary or an app to understand your cycle better and understand when your period is close to arriving or finishing. There are some great Apps available such as Glow, Clue and Clover.
This way, as well as understanding what pain medication works, you can better self-manage symptoms by noting what actions can help. For example, you might feel better with exercise, hot showers or baths, yoga, eating well, meditation, massage and getting more sleep.
Please note: The tips throughout this article serve as broad information and should not replace any advice you have been given by your medical practitioner.
Dr Leigh Exelby
Dr Leigh Exelby is a Queensland-based GP who specialises in women’s health, fertility and children’s health. Her path to medicine was far from conventional, having studied music and business administration and holding down roles in media and marketing before eventually enrolling in medical school. After graduating from Bond University with a Bachelor of Medicine and Bachelor of Surgery, Leigh worked in several hospitals before moving into general practice. Leigh has performed in musicals across Australia and the UK, and rates Michael Jackson’s Smooth Criminal as her favourite song for dancing.