By Shirelle Edghill, Creighton Model FertilityCare Practitioner
Periods are one of those topics that women seem to be able to talk freely about. In this enlightened age people talk a lot more openly than in the past about bodily functions and sexuality. We have definitely come a long way from the days of women going to great pains to hide that they even did menstruate, and the topic being completely taboo, but if we really drill down on this, can women really talk freely about their periods? Ask questions about them? Do you feel comfortable asking your BFF if she has a lot of brown bleeding during her period? Do you ask her how many days she bleeds? How often? Did your mom sit you down and try to tell you what you should expect when it came to your period, and what you should watch out for.
I’m going to guess, probably not.
I think one of the biggest services we as Creighton Model practitioners can offer to women is a safe place to ask potentially uncomfortable questions and finally help women understand just was is a normal period, and what is not.
One note is that if you are on hormonal contraception (the pill, the Mirena IUD, Nexplanon, etc.) this conversation doesn’t really apply. Women who are on the pill may have withdrawal bleeds during times of taking placebo pills, but they are not truly having periods. There really are not standards for how much a woman should and shouldn’t bleed when using these medications, as the woman’s reproductive system is being driven by artificial hormones. I'm going to encourage you to move away from using hormonal contraceptives if you want to find out what is really going on with your body.
Periods should follow an ovulatory event and should be between 3 and 7 days in length. They should follow a fairly predictable pattern, starting off light, going to a moderate or heavy flow, and then back down to light. Another normal pattern would be if it starts moderate or heavy and then tapers down to light or very light spotting.
You might be saying, “Well that sounds like my period,” and I hope that it does. But what exactly does moderate, heavy, and light really mean? Is my definition of heavy the same as your definition of heavy? After all, the only period you’ve probably ever seen is your own. Most women have no idea if the amount that they bleed is a normal amount. Speaking in generalities, heavy is needing to change a regular pad or tampon every 2-3 hours, moderate is changing a regular pad or tampon every 4-6 hours, and light flow would just require a pantiliner to manage. Menstrual cups can provide a very accurate measurement of how much fluid loss (blood + other normal fluids) you have during your period.
Here are some good rules of thumb. Dr. Hilgers, founder of the Creighton Model, and expert on all things related to female reproductive health, is said to have explained that the period should be like a faucet, turning on and then off efficiently. You really shouldn’t be having multiple days of brown spotting before your period really gets going, or at the end of it. These aren’t healthy signs. “Leftover bleeding (as one of my new clients called it)” is not a thing. If you are soaking through regular pads or tampons more often than every 2 hours in one 24-48 hour span of time, this would also be a concerning sign. Some clotting can be normal, as it’s generally caused by a heavy flow pooling and creating a clot. But there would be a range of normal here. Passing huge chunks of tissue is not normal. If you’re using a menstrual cup, you may notice that there is a lot of clear discharge that seems to float at the top, or you may notice that you have a little bit of clear discharge just before your period starts. This is normal. Your period is not just blood-about half of it is actually other fluids, primarily endometrial fluid, which can look like a clear discharge.
We also need to move away from referring to any and all vaginal bleeding as a period. I once had a woman call me in February and tell me she’d been on her period since November. You can’t be on your period for 3 months. That’s not a period. Another situation that likely wouldn’t be a true period would be in the case of a woman who is bleeding every two weeks. Again, some of that bleeding is probably not a period. 8 days of similar brown spotting from day to day, would also not be a normal period. It might seem like semantics, but these things are important when we’re talking about your health. You can’t describe to your doctor that you don’t have normal periods if you don’t understand what a period should look like.
Remember, your period is an important sign of your overall health. Pay attention to what it’s trying to tell you. Have more questions? We'd love to chat with you. EMail Shirelle@InfinityFertilityCare.com