Periods, what is normal? Why are periods different for different women? Some women hate their periods; they have painful cramps, get cranky and feel more emotional. Others revel in a celebration of their womanliness and feel lighter and free after their monthly flow.
Understanding more about periods can help us to manage how we feel. And periods just don’t get talked about in the detail they deserve. So, here we go…
Why do we get periods?
Periods are all about fertility. Every 14 days or so, the brain tells to the ovaries to release an egg in the hope that a sperm will be lurking in the uterus or fallopian tubes. Because, sperm + egg = baby. If there is no sperm, and then no fertilised egg. Your hormonal levels drop and the lining of the uterus (womb) breaks away. This lining, called the ‘endometrium’, becomes the placenta in the event of pregnancy. If there is no pregnancy…viola! Your period arrives every 28 days or so (give or take 3 days).
Hormones such as prostaglandins help the uterus to contract so that the blood flows out. Hence, period cramps. The changes in hormonal levels just before your period is why women sometimes get cranky, teary, moody and pimply. It’s called PMS; short for Pre-Menstrual Syndrome. Or, as it’s sometimes called: ‘Putting up with Men’s S#%*!
What happens when periods first start?
Most girls will have their first period at about age 12, and their final period at 50-51 years of age. That’s about 450 periods; less if you add in a pregnancy or two. Periods will change over your life time because of hormonal influences and the effects of pregnancy and ageing.
Initially, periods can be irregular and heavy. It can take two years before the complicated hormonal sequence that allows a period to occur to be reliably established. If after two years, your cycles are still irregular – say shorter than 21 days or longer than 35 days, it is worth seeing a doctor to have tests to check for problems such as Polycystic Ovarian Syndrome.
How much blood is normal?
The bleeding part of your period should last for about 4-6 days. The blood will initially be bright red, as if flows out more quickly. Clots in the blood happen because the blood mixes with fluid and ‘sets’. After about 2-3 days, it will be lighter, slower and more brown. Sometimes even ‘gritty’. Completely normal. It can also tapper off slowly with just a small amount of brownish blood when you wipe after doing a wee, or first thing in the morning when up stand up (gravity effect: blood accumulates in the top of the vagina overnight and slides out when you go from lying down to standing up).
While is seems like we can loose a lot of blood with a period, it’s usually only 60-80 mls or so. About two tablespoons. It looks like more because it’s mixed with fluids that help it to come out.
Periods during the perimenopause
From the age of 45 or so, our periods can start to change. During the perimenopause periods can become irregular again, lighter or heavier. The hormones get a bit confused and the sequence is a little out of whack. There is a lot doctors can do to help, so don’t just ‘put up with it’.
The female body is an amazing piece of engineering! I would have designed it a little differently…but if we can understand what’s happening, and fix any problems, then it’s not so worrying.
So, if your periods are bothering you, make an appointment make an appointment to see Dr Tonia Mezzini.
Dr Tonia Mezzini is known for offering the best possible advice and treatment options for a person’s sexual health care needs. In particular, she cares for patients with:
- Vulval pain syndromes and vulval skin conditions
- Low libido and pain with intercourse
- Polycystic Ovarian Syndrome
- Gender-affirming hormone therapy
- Complex contraceptive choices
- Sexually transmitted infections such as recurrent genital herpes
- Recurrent bacterial vaginosis
- Recurrent thrush
- Menopause and hormonal concerns
- Chronic pelvic pain in men and women
- Painful periods and endometriosis
- Information about sexual health
- Women's Health after cancer treatment
- Androgen deficiency in men