My usual response to the word ‘normal’ is to chuck it out of the window. But when it comes to periods it’s really useful to know what is considered a normal period and what you should get checked. Certain things can indicate problems, the colour of your period blood for example, and let’s face it…none of us want any more period problems, right?
Firstly, menstrual irregularities aren’t usually an indication of anything serious but they can sometimes signal health problems. In good news, what’s considered a normal period is actually pretty broad and we all know how sensitive our periods are. That means that most changes to your period aren’t because something is wrong with you. Something else could be affecting your cycle such as stress or tiredness. So, to make sure we’re all on the same page, let’s look at what constitutes a normal period.
My Menstrual Cycle Should Last 28 Days…Right?
Wrong. A normal period cycle can last anything from 21 days to 35 days. Normal period flow can last between two to seven days. Of course, we all know that our cycles are sensitive beings and can be affected by all sorts of things.
Stress and tiredness are big factors when it comes to my cycle. If I’m under a lot of pressure my period will normally be late. If you notice changes to your normal period, think about what else could have affected it before jumping to conclusions. Medication, birth control, diet, other health issues can also have an effect on your menstrual cycle so don’t forget to factor that in too.
It’s also totally normal for cycles to last a little longer the younger you are, especially if you’ve just started your period. As you get older, they tend to become shorter and more regular.
You may be one of those people who has a strict 28-day menstrual cycle, with a three day flow period and no symptoms every month. Or you may be one of those people whose cycle is a slightly different length every time and sometimes it’s heavy and sometimes it’s barely there. If it falls in the general range of what’s considered a normal period (21-35 day cycle with 2-7 days of flow) then chances are there’s nothing to worry about.
Period Blood Should Be Red, Right?
Wrong. Again. Normal period blood changes colour depending on the stage of your menstrual cycle. This means that the blood you see at the beginning, middle and end can vary in colour. While this is normal, there are some blood colours that could indicate a problem and are worth getting your doctor to investigate.
Not the sexiest of images but bear with me. Black blood often appears at the beginning or end of a person’s period. It often means that it’s just old blood (the sexy images just keep on coming, don’t they?) or that it’s taken a little longer to leave the uterus and has oxidised. Etiher way it’s generally nothing to worry about.
That being said, if it’s accompanied by any other symptoms such as a bad-smelling discharge, a fever, difficulty weeing or itching and swelling in or around the vagina then it could indicate a vaginal blockage and that’s something you should definitely get checked out.
Brown or Dark Red Blood
A bit like black blood, this is blood that appears at the beginning or the end of your period. It’s generally nothing to worry about but look out for the following things:
Brown blood or spotting can be an early sign of pregnancy and it’s not always something to worry about. Implantation bleeding, which doesn’t sound very warm and fuzzy, is quite normal. However, it’s important to get any spotting or bleeding during pregnancy checked out by your doctor to make sure it isn’t a sign of anything more serious like miscarriage or ectopic pregnancy.
Lochia is the name given to the bleeding experienced after giving birth. This too can be dark red or brown and is no cause for concern. It’s the bodies way of getting rid of excess blood and tissue from the uterus. Totes normal. It generally starts as a bright red colour but transitions to a darker shade as flow decreases over time. Lochia is different for every person, but generally passes within the first few weeks or months following pregnancy. But, just in case you’re thinking, ‘Well, that never happened to me…’ don’t worry. Not everyone experiences lochia so, you know, that’s normal too. If you experience very heavy bleeding for an extended period of time following giving birth, please see your doctor.
Bright Red Blood
If there’s ever a good type of blood during a normal period, this is probably it. Bright red blood indicates a fresh and steady flow and usually occurs right in the middle of your flow. Some women only see bright red blood which is a totally normal period. But, as discussed above, some see a variation in colour to darker shades of brown or black. Also a totally normal period.
Of course, if you see bright red blood between your periods, get it checked out as soon as possible. It could be a sign of a sexually transmitted infection such as chlamydia or gonorrhoea. Other things like polyps or fibroids (both types of growth in the uterine lining) can also cause heavy bleeding.
On rare occasions bright red blood can be a sign of cervical cancer but it will usually come with other symptoms such as:
- Heavier periods
- Longer periods
- Bleeding after sex
- Bad-smelling discharge
- Lower-back or pelvis pain
- Loss of appetite
- Unexplained weight loss
It goes without saying but if any of these sound familiar, please see your doctor.
Blood appears pink when it gets mixed up with cervical fluid. It can also be caused by certain hormonal birth control meds that lower estrogen levels leading to a lighter flow with a pinkish hue. Pink blood can also be a result of small tears in the vagina or cervix and blood from these tears can mix with vaginal fluids and come out looking pink. This is generally nothing to worry about but other causes of pink blood include significant weight loss, an unhealthy diet and anaemia so, if you think these things are happening, it may be worth seeing a doctor to get to the bottom of it.
If you are pregnant and seeing pink blood then it’s important you see a doctor because it could be an indication of a miscarriage, especially if you’re experiencing cramps too.
Sometimes blood that mixes with cervical fluid can also appear orange. Orange blood or discharge is often a sign that there’s something amiss and can indicate an infection such a bacterial vaginosis or trichomoniasis. Infections will generally be accompanied by other symptoms so look out for:
- Vaginal itching
- Bad-smelling discharge
If you see any orange blood, get yourself to a doctor.
A gray discharge is usually a sign of bacterial vaginosis and should be treated by a doctor. Bacterial vaginosis occurs due to an imbalance between the good bacteria and the bad bacteria in the vagina. It usually comes along with other symptoms that would be hard to ignore such as itching, a bad odour (often described as fishy) and pain while peeing. If you experience any of these symptoms, please see your GP.
During the later stages of pregnancy, gray discharge containing clots can indicate a miscarriage so please see a doctor as soon as possible in this circumstance.
How Much Blood Loss Is Normal?
There’s no ‘should’ when it comes to this. Normal blood loss during your period is anything from 5ml to 80ml. ‘But how do I measure my period blood?’ I hear you ask and, to be fair, it’s a good question.
If you use a menstrual cup, they often have volume measurements but that’s assuming you can remove your cup without getting period blood everywhere – a tricky thing to do in my experience. In general though these estimates may help you:
- A fully saturated light tampon can hold up to 3ml of fluid
- A fully saturated super tampon can hold up to 12ml of fluid
- A regular daytime fully soaked pad may hold around 5 ml of fluid
- A fully soaked overnight pad may hold 10-15ml of fluid[i]
A Normal Period Includes Blood Clots, Right?
Right. Generally speaking a normal period will contain small clots which are visible pieces of your uterine lining. They are generally no cause for concern but if you experience very heavy bleeding and large clots then you should see your doctor. It could be a sign of menorrhagia which is when someone experiences heavy bleeding for more than 7 days.
It’s worth seeing a doctor if you have to:
- Change a pad or tampon less than every two hours
- Have clots bigger than a 10p piece.
There’s all sorts of things that can cause menorrhagia so your doctor will need to examine you but if you don’t get it looked at it can lead to anaemia or chronic fatigue.
All Periods Are Painful, Right?
Wrong. Some people experience really bad cramps, some none at all. Some people experience painful and sore breasts, some notice no difference at all. As you get older, the symptoms surrounding your period may become more noticeable and you may notice that they change after childbirth too. A normal period can look very different at different stages of your life so don’t worry if there have been some changes. Keep an eye on them, track it and look out for any of the warning signs.
Symptoms that you may (or may not) experience in the run up to a normal period include:
- Mood swings
- Tender/sore breasts
- Changes to appetite
- Spotty skin & greasy hair
- Loss of libido
- Need to pee more often
Sounds fun, right? Don’t worry. Most of us don’t experience all of these things but it’s worth tracking what you do experience and when. If you ever feel like your symptoms are affecting your way of life, your career, your relationships or your mental health, there’s a possibility you could be suffering from Premenstrual Syndrome (PMS) or Premenstrual Dysphoric Disorder (PMDD).
My Period Shouldn’t Smell, Right?
Well, not really. You will probably notice a smell when you’re changing your pad or tampon because the blood mixing with the naturally occurring bacteria in your body, but it shouldn’t be a smell anyone else notices. Have you ever been able to smell someone else’s period? Probably not.
Sometimes, a normal period may smell a little metallic but unless it’s a noticeably foul smell then chances are all your vaginal odours are totally normal because, and remember this, vaginas aren’t supposed to smell of roses. OK?
My Period Won’t Change As I Age, Right?
Wrong. Apart from the obvious change – the menopause – your period will likely change in length, cycle and colour as you get older. This is generally nothing to worry about but if you develop any of the symptoms listed below, regardless of your age, then you should see a doctor.
Should I Track My Period To Check That It’s Normal?
It’s very helpful to track your period to make sure it stays within the range of what’s considered a normal period. There are plenty of apps out there to help you. There’s a really useful tracker on the iPhone in its Health app where you can track days of flow, symptoms and mood. It’ll also give you a heads up and tell you when to expect your next period which is useful when planning holidays and events. You only have to search on any App Store for a period tracker app to be inundated with a gazillion. Or, if you’re old-skool, a good ol’ diary and a pen will work well too. Whatever works for you.
So, When Should I See A Doctor?
Here’s my advice in the first instance, trust your gut. Go to your doctor if you feel like something isn’t right or just feels wrong. But, if you experience any of the following specifically then it’s also important you see your doctor:
- New or unusual discharge
- Consistently irregular periods
- Bleeding after the menopause
- Missing three or more periods
- Bad-smelling odour or discharge
- Thick gray or white discharge
The important thing to remember is that most periods are very different and most of those are very normal periods. Just because your period doesn’t look or feel like someone else’s doesn’t mean your period isn’t normal. But, it is important to track your period and your symptoms because changes can sometimes indicate other problems and it’s always good to listen when your body is trying to tell you something. There are really useful apps to help you track