Is My Period Normal?

Dr. Erika is a Family Medicine Physician who says that many of her patients are so embarrassed to ask questions about their period. Why are women embarrassed to talk about what happens every single month for several decades of their life? In this interview, Dr. Aragona breaks it down into what's normal and what's not normal. Because a lot of women have no idea.

By Dr. Erika Aragona, MD

Transcript:

Crissy:

We are so excited to be sitting down today with Dr. Erika Aragona. She is a family medicine physician and one of our rock star 2022 HER Expert panelists. Dr. Erika, we’re so glad to be able to sit down and talk with you today specifically, because I’m going to ask you a question that I know, drives every woman crazy. And if not, I’m just going to speak for myself. I need more information on my period, like, what is going on here? Can you talk to me a little bit about what is a normal period? Is there even one?

 

Dr. Erika Aragona:

Yeah, so crazy. I love that you ask it in that way. Like, I need the info help me. Because you know how many of my patients are so embarrassed to ask that question. And I do women’s health. Why? Why are we embarrassed to talk about what happens every single month for gosh, several decades of our life. So we need to break it down into what’s normal and what’s not normal. Because a lot of women have no idea.

 

They don’t talk to their friends about it. They’re certainly not going to talk to their doctor about it. So they’re going around having no clue what is okay.

We need to break it [period] down into what's normal and what's not normal. Because a lot of women have no idea.

- Dr. Erika Aragona

1. DURATION

Okay, so average period, in general, we like it to last about four to five days. If it’s longer than seven, that’s where you’re going to start having doctors say, okay, that’s too long of a period of duration, where maybe we should investigate if something’s going on. So it’s not just the amount or the frequency, but it’s the duration, right? Shouldn’t be bleeding for more than a week, you really shouldn’t. 

 

2. FREQUENCY

So since I mentioned frequency, we always like it to be once a month, everybody talks about their cycles monthly, right? But that can vary by a few days. And that’s okay. And I remember getting this question, oh, my gosh, mine’s every 32 days and my best friends. We didn’t talk about it, thank goodness, I’m glad they’re talking about it. But my best friends is maybe like every 26 days, that’s okay. Your normal cycle is going to vary by a few days. And maybe not just compared to your friends or another woman’s, but yours might not be the exact same every single month. So a lot of women trying to get pregnant can get frustrated by that they’re tracking their cycles. And they’re not really sure when they’re ovulating, because it’s not exactly the same 28 days every time. If it starts to vary by several days, though. So one month, it’s 32 days, then you go 40 days, then you go 15 days, that is a sign to talk to your doctor, because we want you to be on average, fairly typical, month by month. Okay, so frequency is another really big category.

 

3. AMOUNT OF FLOW

Now we’re gonna go to the big one. How heavy is your period? And I will tell you, if I ask a woman is your period heavy? Almost every single one of them is going to say yes. Nobody likes their period, right? I hate my own period. No one likes it. So you have to break it down. What’s heavy? So medically, did you know that you’re supposed to have about three tablespoons of blood? Every period?

 

Crissy:

I did not know that. Actually, I thought it would have been more. I don’t know why I feel like, yeah, I feel like there’s a lot more that comes out.

 

Dr. Erika Aragona:

Yeah, and I agree, because if you think about it, just a couple drops of blood can fill a whole toilet bowl and make it look like it’s consumed with a lot more blood, right? Tampons expand a ton. So it looks like they’re full of blood, when really, the outside might be saturated, but it’s not fully. So what you want to think about is how much blood are you passing? So on average, a woman will pass about two to three tablespoons of blood every month. Over six (basically doubling) that is where we say, Okay, this is way too heavy. But it’s not just the amount.

 

4. CLOTS

You also want to think about the clots. A lot of women say, well, I’m passing clots, what’s dangerous? If you have one the size of a quarter, that’s too big. And that’s a sign also to talk with your doctor. So there’s a lot of factors that come into play.

 

And then something else that I asked by a lot of women is how frequently are you changing your pads or your tampons? Because a lot of the times in the first couple of days, your period’s weigh heavier, normally, and then it tapers off, right? So we start to see spotting, that’s normal, that’s healthy. And that should happen to a lot of women. If you’re changing a tampon every two hours for all five days, that’s way too much compared to maybe changing a tampon every two hours, the first couple days of your cycle and then having it lighten.

Dr. Erika Aragona:

Okay, so that’s a ton. I know. But in a nutshell, when I have a patient come to my office and say, All right, are my periods normal or not. I want to break it down with simple, simple, simple, simple, right? That’s the key.

  • Does it hurt?
  • Are you having tons of cramps, where you’re in so much pain it’s hard to work that’s abnormal.
  • Are you bleeding through your tampons or your pads, that’s usually a sign that it’s abnormal. Not always. But if you’re changing them regularly and you’re still bleeding through, that’s abnormal.
  • If you’re passing large clots that’s abnormal.
  • If it’s lasting longer than a week, or it’s not regular every month for you. That’s abnormal.

 

And what is abnormal mean? Not typical. It’s not super scary. It doesn’t mean something horrible is going on. Tons of factors can change how your periods fluctuate month by month. But if it’s not typical, and it’s causing you discomfort or problems, that’s when I want you to see your doctor.

 

Crissy:

As you just said, it could be any number of factors. Would hormones be a big one? I mean, stress is it just like all the basic things that impact that?

 

Dr. Erika Aragona:

Stress alone can make you miss a period, just so you know. You know how people will see athletes, gymnasts, that really train hard, and they won’t have periods, they’ll just skip them for a long, long time. Or month by month, they’ll have them and then they’ll disappear. That’s very common.

 

So changes in weight changes in exercise, stress, hormonal changes, by far can change that. And we’re not talking about just female dominated hormones, your thyroid can be a big factor as well.

 

So there’s a lot of different things that can cause fluctuations. And I think we should go into a lot more detail. So I’d love to have all of the listeners here, check out your podcast, because there’s so much that we don’t talk about and I want go in detail. Because if you have questions, you want to hear it broken down, easy to understand and know that you’re not alone, because there’s so much stuff that goes into our periods, and we need to talk about it.

 

Crissy:

Thank you so much, Dr. Erika!

Dr. Erika Aragona is a dual board-certified family medicine physician with a focus on preventive medicine and women’s health. In addition to a full time practice, she serves as adjunct faculty at Idaho College of Osteopathic Medicine where she teaches women’s health. She holds an additional degree of a Bachelor of Arts in English, and has used her experience in medical and creative writing to publish a book, A Certain Innocence, as well as author several pieces in national journals including Medscape, The DO, KevinMD and Alpha Phi International. She serves as an expert physician consultant with appearances on national television and social media and writes articles and produces videos for multiple health and wellness companies. Her passion is making medicine cheerful, and with her website, dr-erika.com, she highlights female entrepreneurs as well as discusses positive aspects of medicine.

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