Is there such thing as a 'normal' period?

This is one of the most common questions that I get asked by women trying to conceive and it is a topic that sparks much confusion and debate.

There are many urban myths surrounding our 'time of the month' and some of these supposed 'truths' have become so pervasive, that many women accept them as fact.

Myth No. 1

"A normal period is whatever is normal for you, as no two women are alike"

Well, yes and no. While I agree that we are each unique, it is wholly incorrect to lead a woman to believe that if her period is arriving every 23 days with only 1 day of bleeding that it is okay and that it will have no bearing on her chances of conceiving.

While there are some deviations from the textbook definition of a healthy menstrual cycle, most of us should still be pretty close to the standard 28 day gap. Based on women I have seen in my clinical practice, those who conceive and carry a healthy baby to term are most likely to have had a cycle that is within two days of the 28 day supposed ideal.

So if your period is arriving between 26-30 days apart, and is doing so regularly, e.g. your cycle always arrives after day 29 every month then that is a healthy spacing between periods.

If your cycle is arriving any earlier than day 26 you are more likely to have trouble conceiving because your hormone levels in the luteal phase (second half of your cycle) are dropping too early and this will make implantation more difficult and early miscarriages more likely.

Luteal phase defect is a very common menstrual problem where a woman notices spotting anything from three, up to a ten days in advance of when her period is supposed to start. This symptom should not be ignored as it can make it more difficult to conceive.

If your cycle is typically longer than 30 days and especially if it is 35 days or more apart than you likely have hormonal imbalance. This could mean you have a true or relative excess of oestrogen e.g. swollen breasts and a heavy bleed, or there could be problems with your conversion of testosterone into oestrogen, leading to PCOS type symptoms. e.g. irregular or absent periods, acne, weight gain, cystic ovaries showing up on a scan.If you fall into this category, you should seek professional advice to help correct your elongated cycle.

Myth No.2

"The period itself doesn't matter, as long as you have a bleed, that's fine'

This is a big misconception and it is a real pity that we don't pay more attention to it because the length and quality of a woman's monthly bleed can tell you a lot about the quality of her endometrial lining and the liklihood that she can sustain a pregnancy.

Case Example; A lady came to consult with me a number of years ago who had experienced three consecutive early (prior to 6 weeks) miscarriages. Her period was every 30 days, which was fine, but when it arrived it last for one or maybe two days, max. The blood was brown and sticky and there was no proper 'flow'. She had absolutely no idea what a healthy period was to indicate that she was developing a thick and robust endometrial lining nor had the importance of a proper bleed been explained to her by her Doctor.

She pursued a course of acupuncture, made dietary changes and took the supplements I recommended for her. Within three cycles her period was lasting 3-4 days, with bright red blood, no clots and no stickiness. Her PMS has vastly improved, with a reduction in cravings and her moods were more stable. By month six, she had conceived again and this time carried to term and gave birth to a healthy baby boy.

A menstrual bleed should ideally be no less than 3 days and no more than 7 days in duration. The blood itself might start off pinky/brown but within that day or the next day if your period started in the evening, it should change to a bright crimson red. There shouldn't be big clumps of tissue, nor stringy clots. The flow should be sufficient enough that you require a change of pad every 2-3 hours for the first couple of days. The third and fourth day should be medium flow, still bright red and by the fifth day the period would normally be tailing off and at this point a brown colour is more common as the blood flow is slowing down and has time to oxidise, making it brown in colour.

If your period is regularly less than 3 days in duration, there may be an increased risk of miscarriage due to insufficient endometrial thickeness.

If your period is regularly 7 days or longer in duration then you may be suffering from endometrial growths such as fibroids, polyps or endometriosis, which can alter the anatomical landscape of the womb making implantation more difficult and also increasing the risk of miscarriage.

I hope this has cleared up any confusion on this topic and that you are now more aware of what your period should look like and when it is supposed to arrive.

Stay tuned for my next blog post, which will discuss the dreaded PMS and what steps you can take to improve your symptoms and the quality of your period.