Is my cycle normal?
The average menstruator has ~ 450 periods. Does yours fall within normal parameters?
Hi! This is Lily with your biweekly 3GenWell newsletter. Our belief is that we deserve to know ALL the options when it comes to our cycles, fertility, and reproductive health. I share personal stories and insights from my perspective as a Fertility Awareness Educator, Herbalist, public health professional and woman on my own journey. Today we’re getting into the nitty-gritty of cycle health.
Disclaimer: this information is shared for educational purposes only. I am not a healthcare provider and nothing stated is medical advice.
Is my menstrual cycle normal?
This is a question I hear a lot. It's wild to think, but even as grown women in our 20s, 30s, 40s and beyond, many of us were never taught and still don’t know how to recognize a normal menstrual cycle. If this is you, don’t feel bad. My hope is one day this information will be so basic that writing a post about it would be absurd. Until that day comes, read on.
Why a healthy cycle matters
A healthy cycle within normal parameters is a sign of overall health and hormonal balance. A cycle that is out of range can be an important clue that underlying health issues need our attention. Additionally, having imbalanced cycles means we may not get the benefits of estrogen or progesterone. In addition to reproductive health and fertility, they influence our cardiovascular health, bone health, metabolism, mood, brain health, tissue development, sleep, skin and more. Their balance –think yin and yang–is key.
If we notice a huge change in our appetite, sleep patterns, mood, or bowel movements, we would likely seek medical support, but for some reason when it comes to our menstrual cycle, many of us are still in the dark. We don’t study the monthly signs, and it takes a lot for us to sound the alarm. We are missing out on opportunities to hear the whispers before they’re screams.
Before we get into what is normal, a few notes:
What is common is different from what is normal. This deserves a deep conversation. Typically common means occurring frequently or widespread, whereas normal means standard or expected. For the sake of this piece, I’m using normal to indicate what would be expected in a healthy individual. Many symptoms associated with menstruation including severe cramps and PMS are common but not normal by this definition. That said, I want to acknowledge that there are many reasons we might expect to see shifts in ‘normal’ –our bodies are under excessive stress in modern society including food, exposure to xenoestrogens, our ‘sick-care system,’ the level of toxins in our environment, the influence of technology, and more.
Another distinction is optimal versus normal. There are certain parameters that have a broad range. Knowing what is normal is a starting place, but depending on your goals may not be ideal.
Finally, what is normal is dependent on your life phase. What I’m sharing below is normal for menstruators of reproductive age who are not on any form of birth control. If you’re post-partum, in peri-menopause, or newly cycling (within the first couple years after menarche), it is normal to have variation.
Cycle phases and length
Most broadly, a menstrual cycle consists of two phases. The follicular or proliferative phase includes bleeding to ovulation. The luteal or secretory phase includes the time after ovulation prior to bleeding.
Overall, a normal cycle is between 24-36 days. This includes 3-7 days of bleeding, 3-7 days of progressively more fertile mucus, and 10-17 days of the luteal phase. (Note–there are often additional dry/no mucus days between menstruation and fertile mucus)
Bleeding
It is normal to bleed between 3-7 days, with at least one day of heavy or medium bleeding. Overall, it’s normal to release 40-80ml of blood. FEMM (the certification program I completed), has these parameters to define bleeding:
Heavy: using approximately 5 or more pads or tampons per day (>25ml), needing to change pad at night.
Medium: using approximately 3-4 regular pads or tampons per day (15-25ml), consistent flow.
Light: using approximately 1-2 regular pads or tampons per day (<15ml). Some regular flow.
Spotting is small amounts of irregular bleeding that may require a panty liner, or just be noticeable when wiping.
Pain: Debilitating pain is not normal. Some mild cramping that doesn't overly interfere with daily life may occur, but more intense pain is a sign to take a deeper look. Wanting to slow down, rest and do extra self-are is normal, and ideal, though unfortunately a privilege versus standard for most.
Why this matters: your menstrual blood is the outer lining of your endometrium. It is built up each month to support a possible pregnancy. If the endometrium is not sufficiently established, implantation and sustaining a pregnancy is less likely. Heavier bleeding can also be a sign of health issues, and likewise cause health issues. A normal amount of blood is a sign of health regardless of your baby-making aspirations.
Cervical mucus
Cervical mucus changes throughout our cycles, in response to hormones–mainly estrogen and progesterone. During the first half of our cycle (bleeding through ovulation), estrogen begins increasing. We can tell estrogen is increasing, and we’re nearing ovulation by paying careful attention to our cervical mucus. It’s normal to see:
3-7 days of progressively more “estrogenic” mucus. It may start as a wet or moist sensation and/or be white or lotion-like. As we get closer to ovulation, it’s normal for it to become progressively more clear, slippery and stretchy. There is wide variation in amount and exact attributes of mucus, so this is a general guideline, and you’ll need to do your individual homework.
Why it matters: Cervical mucus has many functions including filtering out abnormal sperm, nourishing and transporting sperm, creating a pH hospitable environment for sperm during our fertile window, and acting as a protective barrier during the luteal phase. Since it changes in response to estrogen and progesterone, with practice, it’s a reliable way to monitor and make sense of your cycle.
Ovulation
It is normal and healthy to ovulate each cycle. Not ovulating–or anovulatory cycles– are a sign something is wrong. During ovulation one of our ovaries releases an egg from a matured follicle. The follicle stays behind becoming the corpus luteum. We typically hear about ovulation occurring on day 14. It is perfectly normal for ovulation to occur a couple days earlier or later. Getting sick or stressed can also delay ovulation in an otherwise healthy person.
An estimated 40% of women experience mittelschmerz, or pain during ovulation. Having more intense or ongoing pain around ovulation is a sign to check-in with a provider. Feeling nothing is also normal. Like many things in women’s medicine, it seems this is understudied for how common it is.
Luteal phase
The corpus luteum produces progesterone (and some estrogen) to sustain the remainder of the cycle. The balance of these two hormones are important. If not enough progesterone is produced, the luteal phase can be extremely challenging–symptoms of low progesterone include sore and tender breasts, mood swings, disrupted sleep, more than one day of spotting, and anxiety. These symptoms are exceedingly common, but not normal.
It’s normal to stop having cervical mucus during this phase, or to notice thicker cervical mucus. It will no longer be stretchy, clear, or slippery.
Having a luteal phase of at least 10 days is an indicator that you’ve produced a healthy corpus luteum. A shorter luteal phase can indicate a poorly formed corpus luteum or other hormonal imbalance. The length of the luteal phase matters for the health of the endometrium, and implantation when trying to conceive. Research has found that longer luteal phases lead to faster conception, but don’t increase overall probability of conception within a year.
Common questions
What if I’m on hormonal birth control?
If you’re on hormonal birth control (patch, pill, etc), you are not ovulating. Your hormones are not cycling. Depending on your specific type of contraception, you may have scheduled withdrawal bleeding. The above guidelines do not apply to this type of bleed, since it’s manufactured and not indicative of your underlying health.
What if I’m on the copper IUD?
The copper IUD interferes with the amount of blood and may alter your cervical mucus. You can use the above parameters, however know that your natural cycle is still influenced by the IUD.
I understand the parameters, but how do I actually track them?
This takes practice! In this essay, I wanted to provide an overview of what’s normal. You can learn to interpret your cervical mucus, detect ovulation, and count the phases of your luteal phase by learning a sympto-thermal tracking method via a book, course, or 1:1 coaching.
My cycle isn’t normal. Now what?
Consider starting with your healthcare provider, if they are not receptive you may need to seek out a specialist, such as a holistic, functional, or integrative practitioner.
Unfortunately many conventional providers don’t understand the importance of cycle health. Many believe what is common is normal, or simply don’t have the training and expertise to be of much help reading your cycle, or identifying underlying issues. If a provider brushes you off, my advice is to find another who is willing to work with you and your period. A Fertility Awareness Educator can also help you better understand your cycle biomarkers and advise on self-advocacy.
In some cases, irregular cycles are hints at an underlying health challenge or diagnosis. For example, PCOS affects 5-10% of people who menstruate –possibly more due to slow and burdensome diagnosis processes. Endometriosis is thought to affect at least 1 in 10. In other cases abnormal cycles are subtle warnings. For example, a short luteal phase could be a sign that your thyroid isn’t operating optimally, or that estrogen is not fully clearing from your system. Identifying these issues early, while they’re a whisper and not a scream is ideal for supporting long-term health.
Key Takeaways
Anyone can learn to ‘read’ their cycle to identify whether it falls within normal parameters.
The menstrual cycle provides us with regular updates on our overall health and wellbeing. It is responsive to our lifestyle, stress levels, and underlying health. Having a cycle within normal parameters is one sign of health, just like clear skin, feeling well-rested, or being able to focus.
Learning what’s normal can become second nature. It’s a way to get in tune with your body so you can proactively address imbalances and support current and future health.
My sources
The following books and training have been influential in my understanding of cycle health and fertility, and informed the parameters I described above.
My FAM certification through FEMM
Fertility Training for Practitioners by Camille Freeman and Liane Moccia
Taking Charge of Your Fertility by Toni Weschler
The 5th Vital Sign by Lisa Hendrickson-Jack
The Period Repair Manual by Lara Briden
Real Food for Fertility by Lily Nichols and Lisa Hendrickson-Jack
The books above are excellent sources if you’d like to go deeper. I also recommend the courses for those looking for professional level training.
Closing
Most of grew up not talking about our periods. When we better understand what’s normal, we can better advocate for ourselves, address any imbalances, and work toward our own optimal level of health.
Knowing what’s normal =health agency!
Please let me know if this was useful and what questions you have.
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