We’re conditioned to expect unpleasant side effects along with our periods: bloating, tender boobs, crashing tiredness, uncomfortable cramps. So we just get on with it – knocking back paracetomol, reaching for hot water bottles, not wanting to make a fuss.
But should we sometimes be making more fuss? It’s impossible to tell what’s going on in each other’s bodies, so while a mate might bemoan her cramps, your womb-shattering, eye-watering pain might be on an entirely different level; her “heavy flow” the equivalent of your lightest day.
So instead of presuming our symptoms are “what periods are” it’s worth asking “Is this normal?”. We asked experts when it’s worth seeking help for period symptoms like bleeding, cramps and clotting – and the signs it’s time to see a doctor.
Is it normal... to be bleeding *this* heavily?
The amount of blood a woman loses during her period differs between individuals, explains Dr Alex Eskander, consultant Gynaecologist at The Gynae Centre. “Most women will lose, on average, six to eight teaspoons of blood [during their period] though up to 80ml (16 teaspoons) is considered normal,” he adds. “Over 80ml in a period and/or having a period that lasts seven or more days is defined as a heavy period.”
Dr Hannah Barham-Brown, an ambassador for the charity The Eve Appeal, adds that “flooding” (bleeding through tampons or towels), is quite common, but can be really disruptive and have a huge impact on people’s lives. “If you’re having to change your product up to hourly, doubling up protection, bleeding between periods, after sex, or having to take time off work, please see your doctor for a check up,” she says.
“We can’t always isolate an exact cause for menorrhagia (heavy bleeding), but causes can include polycystic ovary syndrome (PCOS), fibroids and very occasionally, gynaecological cancer, so it is really important you speak to your GP if you’re worried or something changes – we see this all the time, and we want to help!”
Passing a few small blood clots, particularly towards the beginning of your period, “can be completely normal”, she adds. “If they are bigger than a 10p, or happening frequently, do see your GP.”
Is it normal… to have really strong cramps?
Period pain, or having cramps, is a common symptom and usually nothing to worry about – it tends to be caused by the womb contracting to push out the blood.
Professor Helen Stokes-Lampard, chair of the Royal College of GPs, says for most women, paracetamol and ibuprofen is “usually the most appropriate form of treatment” for period pain. For people with particularly acute symptoms, paracetamol combined with codeine tablets are the strongest form of pain relief patients can buy from a pharmacy. But these should be taken in the smallest possible dose for the smallest amount of time, Professor Stokes-Lampard warns, due to the risk of addiction.
“You should also seek medical attention if your symptoms don’t ease with medication, or the pain radiates to anywhere else in the body as this could indicate something more serious is going on,” Dr Eskander adds.
Is it normal… to be so tired during a period?
If you’re hit by a major wave of CBA when you’re due on your period, don’t panic. “Feeling tired in the run up to your period is quite normal, as your hormone levels drop when your body realises that your uterine lining isn’t housing a fertilised egg, and so that lining can be shed – which is what a period is,” Dr Barham-Brown explains.
The good news is that during ovulation, about two weeks after your period, your energy levels should peak again.
“If you are struggling with tiredness though, particularly if you have heavy periods, it’s worth speaking to your GP to see if you would benefit from some tests into why this could be and whether we can help with it,” adds Dr Barham-Brown.
When else should you see a doctor?
Women’s experiences of periods vary greatly so there is no universal “normal” – but it can be beneficial to figure our what’s normal for you.
“If you notice spotting between periods, any sudden changes to the length of your cycle, the amount of blood, or the amount of pain you are in, then it’s time to see your doctor or gynaecologist,” Dr Eskander says.
Dr Barham-Brown adds that is can really help you and your doctor if you track your periods, either in your diary or using an app on your phone, such as Clue. This will help you to “spot any patterns, and explain easily what’s been going on,” she explains.
They key takeaway is that periods might be annoying, but they shouldn’t be having a huge, detrimental impact. As Dr Eskander says: “If your period symptoms are disrupting your life, preventing you from going out or working, this could be a sign of an underlying condition and it’s best to seek help from a medical professional.”