Whether you call it your ‘Auntie Flow’ or you tell people that it’s your ‘time of the month’, there’s a lot of language we use to avoid talking about periods.
Yet the average woman will menstruate around 500 times in her lifetime, so while they’re not exactly fun to deal with on a monthly basis, periods are a taboo that needs to be addressed, if women are to feel empowered and educated about their menstrual health.
From PMS symptoms to pain, we asked TV’s Dr Sarah Jarvis, resident doctor on BBC Radio 2’s The Jeremey Vine Show, to explain everything you might be wondering about, and give us a better understanding.
1. What is a normal length for a menstrual cycle?
“Women tend to think of 28 days as the average menstrual cycle, but anything between 21 to 40 days is considered normal.
“Irregular periods can happen for all sorts of reasons. Stress, major illness and weight loss can have an affect your cycle, making it shorter.
“The cause could be hormonal too. Missing a dose of your hormonal contraception, taking emergency contraception, the implant and the coil are all common reasons for noticing a change in your period. When you first start taking a hormonal contraception, it can also take a few months for things to settle down.
“As you enter into the perimenopause, the period of time before the menopause occurs, it’s completely normal for your hormone cycle to become less predictable – as your body is less predictably releasing an egg each month. Periods can become more or less frequent during this period, but they rarely become more painful.”
2. Why do some people have heavier periods than others?
“Sometimes it can be normal, but it could also be the sign of an underlying medical issue. One of the major problems we have is that not enough women know that endometriosis and fibroids [non-cancerous growths that develop in or around the womb] can cause heavier and more painful periods.
“Women often don’t realise this is the case and it can take many years to get a diagnosis, particularly with endometriosis. Half of women have fibroids at some point in their life, but most don’t realise they have them.
“It often runs in families too, so a woman may think it’s normal to have heavy or painful periods, but it actually transpires that she and her mother and sisters have all suffered with endometriosis too.”
3. Is PMS a real thing?
“Very much so. What’s interesting is that the symptoms have to occur in the two weeks before your period; within a few days of your period starting, they usually settle down.
“We used to think that PMS was down to a hormonal imbalance, but now we know that some women are more sensitive to normal levels of progesterone, which reduces the levels of the chemicals serotonin and GABA in the brain.”
4. Is there anything you can do to relieve the pain during your period?
“There are lots of different options. Most of us know about hot water bottles and the relief they can provide when applied to the stomach, but interestingly, exercise could help too.
“Research has found that exercising regularly through the month, both low-intensity activities like yoga and high-intensity training like running, all do seem to make a difference to period pain.
“Some women like to use painkillers – anti-inflammatories seem to work best than traditional painkillers – but there are newer gadgets on the market like Livia (uk.mylivia.com), a wearable TENS device that stimulates nerves to block pain. The micropulses work quite quickly and you may be able to get relief in just a couple of minutes.”
5. If I randomly miss a period, is it something to be concerned about?
“It depends if you’re taking a contraceptive or not, such as the hormonal pill, hormonal coil or emergency contraception. You also need to check if you might be pregnant and assess whether you’ve been under a lot of stress recently, as this can cause irregularities to your period.
“A one-off missed period is usually not something to be concerned about, and it’s actually bleeding between periods – or spotting – that I’m more worried about, as this could be a symptom of Polycystic Ovary Syndrome (PCOS).”
6. Is it normal for your period to smell?
“All blood contains iron, so it does smell a bit and it’s natural for there to be a scent.
“If the smell suddenly changes and becomes stronger, you must ask yourself whether you might have a sexually transmitted infection or vaginal bacteriosis, which has a tell-tale unpleasant smell.”
7. Is it possible to get pregnant on your period?
“Technically, yes. You produce an egg two weeks before your period – if you have a very short cycle that’s 21 days long and your period is seven days long, then you could get pregnant.
“Also, sperm can survive very easily for three days, and occasionally up to five days. That being said, you’re at much lower risk of getting pregnant if you have a longer cycle.
“If you’re concerned about your periods, it’s advisable to speak to your GP, who can investigate your symptoms and discuss the best treatment options for you.”