Woman with menstrual crampsWe hear two questions more than the rest, and that tend to stump our patients with regard to their menstrual cycle. They are:

– Do you have normal periods?

– When was the first day of your last menstrual cycle?

For many women, these two questions often lead to many other questions that usually result in a look at the calendar and a brief recap of what a normal period looks like. While it is true that all women are different, menstrual cycles are generally consistent. On average, a woman’s menstrual cycle occurs every 28 or so days, and her actual menses, or period, will last for about 5-7 of those 28 days.

What Is a Menstrual Cycle Anyway? A Day by Day Guide

What Constitutes a Regular Menstrual Cycle?

As we mentioned 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 time frame is generally about 28 days but can range from 21 to 35 days for adult women and 21 to 45 days for younger teenagers. 

In a normal menstrual cycle, you won’t be aware of the reproductive activities that take place throughout your entire menstrual cycle. The exception to this is the days leading up to the start of your cycle, when women experience the pre-period symptoms such as headaches and cramps, and when you are ovulating, which can sometimes lead to slight cramping and very light spotting. Learn more about what an irregular period can mean here.

As expected, you will also be very present to your body’s changes during your period, which is when your uterus sheds the old endometrial lining in preparation for the next round of ovulation.

Days 1-7. 

This is when 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 to 3. The average period lasts between 3 to 5 days. Some women experience very light periods, while others experience very heavy periods. This is all dependent on your body.

You may experience bloating, cramps, or discomfort in your pelvic area and/or lower back during this time. This is completely normal and can be addressed using over-the-counter pain medication and anti-inflammatories. 

If the pain and discomfort are severe, you should seek an appointment with your doctor.

Day 7 – 11

This is often referred to as the “follicular phase” and occurs when the follicles on the ovary mature and prepare 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 potential fertilized egg.

Around the 11th day, the egg is ready to be released. This is called “ovulation,” when many women try 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 that you learn your cycle so you can time sexual intercourse with the days preceding and during the egg’s release. Since sperm can live up to 5 days or more, you can have sex leading up to the “release date” and have a higher chance of conception.

Day 11 – 14

In most cases, this is the ovulation window, although it can go beyond day 14. Your mature egg will be released sometime in this window, so this is the time to try conceiving. Your estrogen levels will still be peaking, and your testosterone levels will begin to rise, which can lead to an increased libido. This is the body’s way of encouraging reproduction, as it knows that this is when you are most fertile.

Day 15 – 17.

Your estrogen and testosterone levels will begin to drop during this time frame, but your progesterone levels start to elevate. The egg will continue to make its way down the fallopian tubes while it seeks to be fertilized. If it becomes fertilized, your hormone levels will shift to facilitate the official start of pregnancy. If the egg remains unfertilized, your cycle will continue as normal. 

Day 18 – 20. 

Around here, your estrogen levels will begin to elevate again, and progesterone levels will remain high. That unfertilized egg will eventually die and become absorbed by the body as the end of your cycle grows closer.

Day 21 – 28

Your luteal phase begins the day the egg is released, so if your cycle is right on “average,” the egg release will have been day 14. However, it can be as late as day 20 or so, depending on your body and its own process. 

During the last phase of your menstrual cycle, you will likely experience classic pre-period symptoms such as bloating, acne, mood swings, and weight gain. Progesterone levels will begin to drop again, and your estrogen levels will taper off.

Talk to your OB/ GYN if you feel your menstrual cycle isn’t adhering to the average.

When Should I See a Doctor?

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 cycles.
– You bleed for longer than seven 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 want to learn more, contact Overlake OB/GYN. We are here to help, teach and reassure you every step of the way.