What's a Normal Menstrual or Period Cycle?

We sat down with Elix medical advisor and board certified minimally invasive gynecologist, Dr. Jessica Ritch to answer your questions about menstrual cycles and preventative health and wellness.

Dr. Ritch helps to treat patients and get them back to their lives faster through behavioral modifications, physical therapy, medical treatment and surgical treatment including robotic surgery, advanced laparoscopy, hysteroscopy and vaginal procedures. Dr. Ritch specializes in the management of benign gynecologic conditions such as abnormal bleeding, pelvic pain, fibroids, endometriosis, and polycystic ovarian syndrome. Today, Dr. Ritch is going to go over all the basics of what defines a normal period cycle. 

What is the average length of a menstrual cycle?

Menstrual cycle length varies from person to person, but typically ranges between 21-35 days from the start of one menses to the start of the next. Using a cycle tracking app can help you stay on top of your cycle patterns and understand what’s normal for you as most menses do not follow a calendar date specifically. It’s important to note changes such as missing a period, phantom periods, fluctuations in mood or behavior, spotting between cycles, and length of bleeding, so you can be more informed when you go see your doctor. While mild cycle irregularities usually aren’t serious, sometimes they can signal health problems.

How much blood should I lose on my period?

Medically speaking, around 80ml of blood in a menses is considered normal, but again this can vary from person to person. What's a normal period cycle to one person may not be normal to the next. I can get a sense of what my patient’s bleeding is like based on how often they change their menstrual cup, tampon, or pad.  What matters most is how bothersome the bleeding is to you and if it’s causing other issues like anemia. If the amount you bleed every month is disrupting your life and making it difficult to do certain activities, then you should definitely bring this up to your doctor.

Is pain during my period good or bad?

A little bit of cramping is normal, but if the pain is bothering you to the point where you can’t get out of bed to go to work or school, or if you require a lot of medication to get through your day, then that is not normal. If you are suffering from severe period pain, have back spasms, or feel pain in your legs or other areas of your body during your cycle, then this could indicate endometriosis or other conditions.  Menses should not be something you have to suffer through each month or something that keeps you from  work, school, or the things you enjoy.

Should I have breast pain during my period?

Having sore breasts before your period is completely normal, but it definitely can be bothersome. During this time your body can create an excess of estrogen which causes the breasts to swell and become tender. The soreness is usually due to hormone fluctuations and typically goes away at the start of bleeding If pain persists beyond menses or ovulation, you should discuss this with your doctor.

Why does it hurt to poop while on my period?

Digestive issues during your period such as constipation and diarrhea are really common due to changes in the hormones progesterone and prostaglandins.  These hormones and small amounts of bleeding that escapes through the fallopian tubes can irritate the bowels and lead to bloating, diarrhea and constipation.  This is even worse in women with endometriosis around the bowels.

What additional resources do you recommend I use to learn about my cycle?

For general information on menstrual health: 
Mayo Clinic

For finding providers:
AAGL
IPPS

For minimally invasive gynecology problem and treatment-based information:
MIS For Women 
Florida Center for Urogynecology


Looking for a natural way to support your cycle? Try out Cycle Balance! Take our online health assessment and receive a personalized blend of herbs to ease your worst menstrual symptoms.