Periods – What you need to know

The female body is amazing! As women, it is important to understand how our bodies work, including our menstrual cycle. Knowing the facts will give you confidence to understand any changes you may experience.

How does the monthly cycle work?

For the average 28-day cycle, the egg is released from one of the ovaries about 14 days after the start of a woman’s period. This is called ovulation. One egg is released and could be fertilized. The timing of the egg’s release is different for every woman.
A woman is most likely to get pregnant in the few days leading up to ovulation and the day of ovulation. Once ovulation has occurred, the egg can be fertilized for 24 hours. Sperm can live inside a woman’s body for 3 to 4 days.
If the egg and sperm meet, an embryo is formed, which is called fertilization. The embryo then attaches to the uterine wall, where it will grow and develop.
If an embryo is formed, the woman will miss her period or experience a light period.
If no embryo is formed, the uterus will shed its lining through the vagina, and this is the woman’s menstrual period. Menstrual bleeding can last between 2 to 7 days.

What is a normal period?

The menstrual cycle is counted from the first day of one period to the first day of the next. The cycle is not the same for everyone. Menstrual bleeding might happen every 21 to 35 days and last 2 to 7 days. For the first few years after menstruation begins, irregular cycles are common. However, menstrual cycles tend to shorten and become more regular as women age.

Your menstrual cycle might be regular or irregular. Your period might be light or heavy, painful or pain-free, long or short, and still be considered normal.

Certain kinds of birth control, such as extended-cycle or hormonal birth control and intrauterine devices (IUDs), will change a menstrual cycle. If you use hormonal birth control, talk to your health care provider about what to expect.

What can I do if my periods are painful?

Menstrual cramps can range from a mild ache to severe throbbing or cramping pain in the lower abdomen. Many women have cramps just before and during their periods.

Some women experience painful cramps that disrupt their everyday lives.

In some cases, severe cramps are caused by a condition such as endometriosis or uterine fibroids. Treating the cause is key to reducing the pain. Menstrual cramps that are not caused by another condition tend to lessen with age and sometimes improve after giving birth. Talk to your medical provider if you are experiencing cramps that affect your daily activities.

Common symptoms of menstrual cramps include:

Cramping pain in your lower abdomen
Pain that starts 1 to 3 days before your period, peaks 24 hours after the start of your period, and stops in 2 to 3 days
Pain that sometimes radiates to your lower back
Nausea, headache, and dizziness, in some extreme cases

You should see your medical provider if you have cramps that affect your everyday life, your period symptoms get worse, or you start having intensely painful cramps after age 25.

What causes painful cramps?

According to the Mayo Clinic website, “During your menstrual period, your uterus contracts to help expel its lining. Hormone-like substances (prostaglandins) involved in pain and inflammation trigger uterine muscle contractions. Higher levels of prostaglandins are associated with more-severe menstrual cramps.”

Painful cramps can be caused by:

Endometriosis. Tissue like the lining of the uterus grows outside of the uterus, most commonly on the fallopian tubes, ovaries, or the tissue lining your pelvis.
Uterine fibroids. These noncancerous growths in the wall of the uterus can cause pain.
Adenomyosis. The tissue that lines your uterus begins to grow into the muscular walls of the uterus.
Pelvic inflammatory disease. This infection of the female reproductive organs is usually caused by a sexually transmitted infection (STI).
Cervical stenosis. In some women, the opening of the cervix is small enough to impede menstrual flow, causing a painful pressure within the uterus.

You might be more likely to have painful cramps if:

You are under age 30
You started puberty at age 11 or younger
You bleed heavily during periods
You have irregular periods
You have a family history of painful cramps
You smoke

Talk to your medical provider if you suspect you may have one of these conditions.

Should I track my periods?

Many women find keeping track of their periods to be helpful, especially if they are trying to get pregnant or avoid pregnancy.

To find out what is normal for you, start keeping track of your menstrual cycle on a calendar or app such as Flo: Period Tracker or Natural Cycles. Track your start date every month for several months in a row to identify how regular your periods are.

If you’re worried about your periods, also track the following every month:

How long does your period typically last? Is it longer or shorter than usual?
Record the heaviness of your bleeding. Does it seem lighter or heavier than usual? Have you passed any blood clots?
Are you bleeding between periods?
Does the pain feel worse than usual?
Have you noticed any changes in your mood or behavior? Did anything new happen around the time you noticed changes in your periods?

What can cause my period to be irregular?

According to the Mayo Clinic, menstrual cycle irregularities can have many different causes, including:

Pregnancy or breast-feeding. A missed period can be an early symptom of pregnancy. Breastfeeding sometimes delays the return of your period after pregnancy.
Eating disorders, extreme weight loss, or too much exercise. Disorders, such as anorexia nervosa, extreme weight loss, and higher physical activity, can interrupt your period.
Polycystic ovary syndrome (PCOS). People with this common disorder may have irregular periods.
Premature ovarian failure. Premature ovarian failure refers to the loss of ovarian function before age 40. People who have this condition, also known as primary ovarian insufficiency, might have irregular periods.
Pelvic inflammatory disease (PID). This infection of the reproductive organs can cause irregular menstrual bleeding.
Uterine fibroids. Uterine fibroids are growths in the uterus that are not cancerous. They can cause heavy and prolonged menstrual periods.

What should I do if my periods are irregular?

According to the Mayo Clinic website, talk with your health care provider if:

Your periods stop for more than 90 days, and you’re not pregnant.
Your periods become irregular after having been regular.
You bleed for more than seven days.
You bleed more heavily than usual or soak through more than one pad or tampon every hour or two.
Your periods are less than 21 days or more than 35 days apart.
You bleed between periods.
You have severe pain during your period.
You get a fever and feel sick after using tampons.

If you have questions or concerns about your menstrual cycle, talk to your healthcare provider.

If you have missed your period and think you might be pregnant, text Mercy at 484-946-3885 to make a confidential appointment.

https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/menstrual-cycle/art-20047186

https://www.mayoclinic.org/diseases-conditions/menstrual-cramps/symptoms-causes/syc-20374938