Periods, periods, periods - Oh, the joys!
I still remember when I got my first ever period - I was 12, and my mum had been predicting "I think you'll get your period this week" for six months prior to it's anticipated arrival. I went for a wee, and my undies revealed a spot of blood. All I could do was cry.
I sat on mums bed while she comforted me about how it was all going to be okay when my younger brother took it upon himself to kick me in my state of hormonal, emotional vulnerability. He taunted me, probably with something along the lines of "ewww you're bleeding; that's gross". In quick retaliation in defense of her girl mum flew back with "well, I'd rather have a period every month than have to live with two balls between my legs everyday for the rest of my life". It's one of those moments that she still looks back upon and questions whether that was great parenting, but to this day it's one of my favourite memories.
Since then, I've had what could only be described as a tumultuous relationship with my period. I still continue to struggle with pain, fatigue, emotional fluctuations and irregularity, and I know many other women do too. So what is a normal period, why do we get them, and what are the signs that somethings not quite right?
The Menstrual Cycle
We can't talk about periods without first having an overview of the menstrual cycle; the process in which a females body prepares for pregnancy. The TedEd video below has an informative and concise description of what the menstrual cycle is. If you haven't already been through to content on the Reproductive Anatomy and Physiology page, I'd recommend you head over there first to set your self up with the foundation knowledge required to understand your body.
What's considered 'normal' differs between woman to woman. For the most part though, a normal period is one that is regular - meaning that it arrives within 28-36 days of the last routinely, lasts between 3 to 7 days, and is consistently light or heavy month to month. Some people will have cramping in their lower abdomen - known as dysmenorrhea - or lower back pain for the first couple of days. Other symptoms include headache, mood changes and fatigue. When you're starting to get your period the best way to determine what's normal for you is to write down your symptoms. Track the dates, monitor how your feeling - including your moods - and how heavy your period is. It's normal for your period to be all over the place initially, but if this continues then some further investigation may be required. This is also the case for pain that cannot be eased with over the counter pain killers, excessive changes to mood or depressive episodes, and migraine or severe headache. Periods should not be debilitating, and they should not impair your quality of life - if they are it's best to look a little deeper (The Royal Womens Hospital, 2018; Tortora & Derrickson, 2014, pp. 1070-1074).
Oh girl - where to start?! Crippling period pain is not "normal". Pre and post-menstrual fatigue need attention. Devastating bouts of menstrual cycle related depression and anxiety are dangerous. There's many reasons periods can be problematic. Let's start with some terminology:
Dysmenorrhea: Pain present in the pelvic region shortly before and during menstruation (Melville, 2015).
Amenorrhea: "The cessation or absence of menstrual periods" (Melville, 2015, pp. 27).
Primary Amenorrhea: "Failure to commence menstruation by 16 years of age with normal secondary sexual characteristics, or by 14 years of age in the absence of other evidence of puberty" (Melville, 2015, pp. 27).
Secondary Amenorrhea: "Absence of menstruation for 6 or more consecutive months in a woman with previously regular" periods (Melville, 2015, pp. 27).
Oligomenorrhea: Irregular periods at intervals of 35 days or more, but less than six months (Melville, 2015).
These are all reasons to consult a medical practitioner, as they're key indicators that something might not be quite right. They're all signs and symptoms of reproductive pathologies, or other underlying issues that may have long term implications on your general health and well-being. When visiting a doctor about problematic periods it's best to have things written down - that's where keeping a track of your last period and your regular menstrual cycle symptoms comes in handy. For more information head over the the Reproductive Pathologies page.
Resources and Tools
"From first periods to first coils, pimples to hot-water bottles and PCOS to endometriosis, The Hormone Diaries is your essential companion on the hormone rollercoaster. Filled with Hannah's insights, fascinating research and those priceless crowdsourced stories, it's the reassuring hug we all need."
"This little book is packed with honest advice on all the things you need to know: from what cramps feel like to whether you can feel it coming out, to what you should do if your pad leaks onto your clothes.
Welcome To Your Period includes case studies, first-person accounts and questions from real teens (and answers from real experts – us!) so you can manage your period like a boss."