What is a “Normal” Period

Periods are a normal part of life and can give clues about our reproductive and general health. Working as a GP, I have seen many women who just assume that their heavy or painful period is “normal” and that they should just have to deal with it, even if it means taking days off school or work, or having to wear a pad and a tampon for fear of embarrassing accidents. Periods like this are not normal. Your period should not overly disrupt your day to day life, other than possibly having to quickly get to the supermarket if you are running low on menstrual products.

Periods are often irregular when they first start or when a woman is approaching menopause. The average cycle length is between 25-30 days, but it can vary between 21-45 days. Irregular or prolonged menstrual cycles, known as oligomenorrhoea, or not getting a period, known as amenorrhoea, can be caused by many different things, such as hormonal problems, sudden weight loss or weight gain, stress, contraception or pregnancy and breastfeeding. If your period is irregular or you haven’t had a period for 6 months or more, it is important to see your GP to have it assessed and underlying medical problems ruled out.

Heavy periods, medically known as menorrhagia, are defined as greater than 80mL of blood loss per cycle. Realistically, no one is measuring their menstrual blood loss like this. A more simplified way to assess heavy bleeding is if you are needing to change a pad or a tampon more frequently than every 2 hours, you are passing blood clots bigger than a 20c piece, or bleeding is lasting longer than 7 days. Flooding, where bleeding is not contained by a pad or tampon, can also be a sign your period is heavy.

Heavy periods can be an indication of an underlying medical condition. There can be hormonal causes, uterine causes or disorders of blood clotting. Heavy periods can lead to iron deficiency and anaemia, which in turn can cause significant fatigue. It is important to have your heavy periods assessed by a GP to rule out any underlying causes, but also to discuss treatment options with you – there is a lot more available than the pill!

Painful periods, or dysmenorrhoea, is excessive pain that disrupts daily activities. Some pain is common on day 1-2 of your period, but should be easily managed with simple pain killers. Significant period pain can cause a number of physical symptoms and cause you to miss work or avoid going out. Diarrhoea, vomiting, fainting and pain radiating into your legs or low back can all be signs that your pain is excessive.

Painful periods can also be an indication of underlying medical conditions, such as endometriosis or adenomyosis. I have seen many women who feel their pain has been dismissed as normal in the past, when it is having a significant impact on their functioning every month. If you feel you have excessive period pain, you should see a GP to be assessed and to discuss treatment options, again there are other options that are not the pill.

In summary, a normal period should come regularly and not have too much impact on day to day life. If you feel any of the above symptoms affect you, please see your GP to discuss possible causes and the best treatment options to suit you.