Most doctor’s visits begin with the collection of vital signs which include body temperature, pulse rate, respiration rate, and blood pressure. These things are easily measured and tracked over time, and can give us important insight into the overall status of our health. While undoubtedly important and useful, the aforementioned list of vital signs omits one of the biggest indicators of a woman’s health: our menstrual cycle.
The four main vital signs aren’t typically measured routinely, but rather just a few times per year in medical settings. Our menstrual cycles, on the other hand, are a daily part of life and provide continuous feedback and insight into the status of our health. We sat down with Morgan Smith, PhD, CSCS, to learn about normal menstrual patterns, things that might cause abnormalities, and when it might be time to seek assistance from a medical professional.
What is a “Regular” Menstrual Cycle?
While no two women will have identical cycles, there are certain parameters that indicate whether or not ours are regular and healthy. It should be noted that, for the purpose of this article, we discuss regularity in the context of naturally menstruating women who are not on any form of hormonal contraception.
According to Smith, the first indicator of healthy menstrual function is having a first period before the age of 15. Cycles may be irregular for the first one to two years after our first period, but this is common. But this is nothing to be concerned about because it tells us that our bodies are continuing to mature and adjust.
After the first one to two years, Smith says that our menstrual cycles should regulate and follow patterns including a cycle length (the number of days between periods) of 21 to 35 days and a bleed duration of two to seven days. When it comes to norms for period flow, Smith notes that these are not as strongly defined but that current research considers a heavy flow to be one in which we have to change our tampon/pad/cup/underwear every 1-2 hours. In cases of a heavy flow, she advises seeing a doctor for a check-in. It’s also a good idea to check in with a doctor if you notice variations from your own patterns, even if these variations still fall within the previously defined “normal” ranges.
“It’s very important to differentiate between ‘normal’ vs. ‘common.’ Just because something is common, does not mean it’s normal.”
What to Do if You Skip or Lose Your Period
As women athletes, it’s unfortunately common to have delayed, missed, or lost periods, but Smith reminds us that it’s important to differentiate between “normal” and “common.” “Just because something is common, does not mean it’s normal,” she says. “For example, if most girls on your team are over 15 years old and don’t have periods, that is common, but not normal!”
If we find ourselves in situations where a coach, teammate, or even a doctor tells us menstrual irregularity is normal, Smith encourages us to advocate for ourselves. With doctors, she advises asking questions and not being afraid to get a second opinion if you don’t feel like you are leaving your appointment with action items and clarity. She reiterates that it’s not normal to just lose our periods.
Why Might My Period Become Irregular or Disappear?
“Getting a regular menstrual cycle can tell us that our body is properly producing the hormones it needs and is in a state to create these hormones,” Smith points out. So, menstrual irregularity is an important signal that something is off within our body and we need to determine the cause.
According to Smith, there are many factors that can play into menstrual irregularity, including, but not limited to, the following:
Pregnancy
Improper nutrition/female athlete triad/Relative Energy Deficiency in Sport (REDs)
High levels of stress – from school, travel, grief (both personal and sport related), and more.
Too much training and/or exercise
Trauma
Diseases/infections – ex. Polycystic Ovary Syndrome (PCOS)
Certain medications
If we’ve lost our periods, it’s important that we consult and work directly with a physician to determine which of the above factors are at play in our individual situation. Smith notes that each cause of menstrual irregularity has a unique care plan that licensed professionals can guide and support us through.
While menstrual cycles and periods may seem like an inconvenience, at the end of the day, we should actually be thankful to have them as valuable indicators of our overall health as women athletes. It’s important that we each keep track of our own unique patterns and discuss any variations with qualified medical professionals to ensure that we’re ready to perform at our best, both inside and outside of sport.
