Two questions that seem to stump our patients on a regular basis are:
- When was the first day of your last menstrual period?
- Do you have normal periods?
For many women, these questions open the gate to a host of other questions requiring a quick look at the calendar and a brief synopsis of what a normal period would be. While it’s true that all women are different, menstrual cycles for the most part are fairly straightforward. On average (emphasis on those first two words), a woman’s menstrual cycle occurs every 28 days or so (give or take a few days) and her actual menses, or period, will last for about 5 to 7 of those 28 days.
What Constitutes a Regular Menstrual Cycle?
As we stated above, the menstrual cycle is the length of time that spans from the first day of your period until the day before your next period. This is typically about 28-days in length, but can range from 21 to 35 days in adult women, and 21 to 45 days for younger teenagers.
Under normal circumstances, you will be oblivious to the reproductive activities that take place throughout the entire menstrual cycle. The exception is the days leading up to the start of your cycle, when some women experience symptoms of PMS, and right when you ovulate, when some women report slight cramping and very light spotting. Of course, you will also be very present to your body’s changes during your period, when the uterus sheds the old endometrial lining in preparation for the next round of ovulation.
Days 1-7. This is the day that you see the first spotting or experience bleeding when the uterus begins to lose the thickened endometrium. For most women, the bulk of the blood loss occurs during days 1 – 3. The average period lasts between 3 to 5 days. Some women experience very light periods, others experience very heavy periods; it all depends on your body.
During this time, you may find that you are bloated and that you have cramps or discomfort in your pelvic area and/or lower back. This is completely normal and can be addressed using over-the-counter anti-inflammatories and pain medications. If the pain and discomfort is severe, you should make an appointment with your doctor.
Day 7 – 11ish. This period of time is often referred to as the “Follicular Phase,” and occurs when the follicles on the ovary mature and prepares to release the egg(s). During this phase, your estrogen levels will rise and the lining of the uterus will begin to thicken again, in preparation for a potentially fertilized egg. Around the 11th day, the egg is ready to be released. This is called “Ovulation” and is what many women try to predict in order to time sexual intercourse with the most likely time to be fertile. There is a very small window of time (roughly 24-hours) that an egg can be fertilized. So, if you are trying to conceive, we recommend learning your cycle intimately so you can time sexual intercourse with the days preceding and during the egg’s release (sperm can live up to 5 days or more, waiting for this momentous occasion).
Day 11 – 14. In most cases, this is the ovulation window, although it can also stretch beyond day 14. Your mature egg will be released somewhere in this window of time. Estrogen levels are still peaking and your testosterone levels will begin to rise, which may increase your libido – the body’s way of encouraging reproduction.
Day 15 – 17. Now, the estrogen and testosterone levels will begin to drop, while progesterone levels elevate. The egg will continue to make its way down the fallopian tubes in the hopes that it will be fertilized. If it is, your hormone levels will do other things to facilitate the official start of pregnancy. If the egg is unfertilized, your cycle will continue as normal.
Day 18 – 20. Your estrogen levels will begin to elevate again and progesterone levels remain high. That unfertilized egg will have died and become absorbed by the body. The end of your cycle is right around the corner.
Day 21 – 28. Your luteal phase begins the day the egg is released, so if you are right on “average” schedule, that will have been day 14, but it can be as late as day 20 or so depending on your body and its own process. During this last phase of your menstrual cycle, you are the most likely to be plagued by PMS symptoms, like bloating, acne, mood swings and weight gain. Progesterone levels begin to drop again and estrogen levels will taper off.
Feel like your menstrual cycle is not quite right? Talk about it with your OB/GYN. Typically, we recommend seeing a doctor if:
- You haven’t begun menstruating by age 15 or within three years of the first signs of breast development.
- You haven’t had a period in three months or more.
- Your periods have become very irregular after having very regular cycle.
- You bleed for longer than 7 days.
- Your bleeding seems much heavier than normal and lasts for more than a few days of your period. Heavy bleeding is indicated by having to change your pad or tampon more than once every hour or two.
- Your periods occur more frequently than every 21 days or you consistently go more than 35 days at a time without your period.
- You bleed in between your periods.
- You get sick or run a fever during your period.
- You experience intense pain or discomfort during your period.
If you are concerned that your menstrual cycle is abnormal or just want to learn more about it, contact Overlake OB/GYN. We are here to help, teach and reassure you every step of the way.