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We spoke with Dr. Jeanne Bouteaud, OBGYN, Menopause Specialist, and Medical Consultant at Coral, about painful periods and when to seek medical support. While period pain may be common, it is often not normal, and there are support and treatment options.
What's normal?
A “normal” period experience does not prevent you from living your life. If you are missing school or work, if you're not able to do your day-to-day activities, that is not normal.
Painful periods are often normalized. When should someone actually be concerned?
In today’s culture, painful periods are unfortunately normalized. I see a lot of patients suffering in silence. It's really important that you seek medical support if your period pain is impacting your ability to function every day. Seeking support early is key. Your period should not be preventing you from living your life.
Menstrual Cycle Length and Duration:
As periods are cyclical, they have their own rhythm and patterns. These will vary from person to person, and sometimes, month over month. When we talk about the length of a period or menstrual cycle, we mean the time between the first day of your period to the start of the next. If your cycle is coming more than every 21 days, or if your cycle is longer than 35 days, this is outside of the normal range, and we recommend talking with a healthcare provider.
In terms of duration of your menses, if you are bleeding for longer than seven days each month, this is a sign of something outside of the normal range that requires medical support.
Menstrual Flow:
The determined average for menstrual flow is 30 to 40 milliliters per menstrual period, or 2 to 3 tablespoons. If you find you have to change protection more than every two hours, you get up overnight to change product, or you have to use double protection, we consider that to be a heavy flow worthy of attention and investigation.
Pain and Menstrual Cramps:
In terms of what pain level should be considered normal or abnormal, this is less of an actual number on the pain scale and more about your experience. A better way to gauge pain is if your period pain is preventing you from functioning in your day-to-day life; that’s not normal. If you have to take multiple pain medications to be able to function, if you're missing school, work, fitness activities, or you don't want to go out with your friends because it's too uncomfortable or painful, your menstrual and/or pelvic pain is not normal and should be looked into by a healthcare provider for treatment options.
Menstrual Clotting:
The presence of a clot is usually associated with a heavier flow. If you're passing clots, that would be considered an abnormally heavy flow, and you should be discussing this symptom with a medical provider. If a heavier menstrual flow is left untreated, you are at risk of developing other conditions like anemia. Anemia can cause other symptoms like fatigue and headache, and lower your ability to function.
Everyone will have a different experience of menstruation, and symptoms will vary across the life stages. When younger, longer or heavier cycles carry different risks than if you are over 40 and have other health concerns.
Regardless of age, abnormal period symptoms need to be assessed and treated.
Period symptoms can impact your overall health and wellbeing. An abnormal period can be a reflection of an underlying health issue. Don’t neglect the signs that your body is sending you.
How to talk to your doctor about abnormal period symptoms:
If you have a painful period or abnormal frequency or flow, track it, and book an appointment with your healthcare provider! Tracking your period with an online app or day planner will provide invaluable insight into your period health. Data and information are the best way to advocate for yourself and get the most out of a medical appointment. Record your period frequency, flow, pain, mood, sleep quality, and other symptoms for at least three months.
Questions to consider:
- How many days are you bleeding for?
- What are the heavy days?
- Do you have to get up at night?
- Do you have to use double protection?
- Are you passing clots?
Severity Tracking:
In addition to symptom tracking, track severity. How much of an impact is your period having on your life? Record if you miss school, work, fitness activities, social outings, and medication intake. Listing dosage and effectiveness of medication can also be helpful.
Period pain may be common, but it doesn't mean that it's normal. If your period pain is impacting your life and preventing you from doing the things that you want or like to do, then it's time to seek care.
