Are my periods normal? Understanding Your Menstrual Cycle

Periods, also known as menstrual cycles, are a natural and healthy part of life for people with uteruses. During this monthly cycle, the lining of the uterus (womb) breaks down and sheds as blood and tissue. This process happens because the body prepares for a potential pregnancy. If pregnancy doesn’t occur, the lining sheds, and menstruation begins.

Despite being a common experience, what’s considered 'normal' can vary greatly from one person to another. For girls just starting their periods, it might take a couple of years for their cycles to become regular. Women approaching menopause may notice their periods becoming irregular, often a sign of the approaching change. Stress, medical conditions, and intense exercise can also influence your menstrual cycle, making it seem erratic.

Understanding what’s normal and what isn’t can be tricky. That’s why we’re here to clarify typical menstrual patterns and guide you on what steps to take if your period seems abnormal.

Normal Period Patterns According to FIGO

FIGO, the International Federation of Gynecology and Obstetrics, has created guidelines to help you understand what’s typical for menstrual cycles and what might be considered abnormal. Here's a simple breakdown to help you figure it out.

1. Frequency:

•      Normal: Your period comes every 24 to 38 days.

•      Abnormal: Your period comes more often than every 24 days or less often than every 38 days. If you’re not having periods at all, it’s called amenorrhea.

2. Duration:

•      Normal: Bleeding lasts up to 8 days.

•      Abnormal: Bleeding lasts more than 8 days.

3. Regularity:

•      Normal: The number of days between your periods varies by 9 days or less if you’re 18-25 or 42-45 years old, and by 7 days or less if you’re 26-41 years old.

•      Abnormal: If the variation in your cycle length is greater than these ranges, your periods are irregular.

4. Flow Volume:

•      Normal: The flow is manageable and doesn’t interfere much with your daily life.

•      Abnormal: The flow is very heavy or very light, making it hard to go about your day.

 Other Considerations:

Intermenstrual Bleeding (IMB): Any bleeding between your regular periods is abnormal. It might happen randomly or at specific times in your cycle (early, mid, or late cycle).

Unscheduled Bleeding on Hormone Medication: If you’re on birth control or other hormone medications and experience unexpected bleeding, it’s considered abnormal.

When to Seek Help

If your periods don’t fit into these normal ranges, it might be a good idea to talk to a healthcare professional. Here are some signs you should look out for:

•      Sudden changes in your menstrual cycle.

•      Very heavy bleeding or large clots.

•      Severe pain that over-the-counter meds can’t relieve.

•      Bleeding between periods or after sex.

•      Periods that last longer than 8 days or come more often than every 24 days.

•      Understanding what’s normal can help you take charge of your menstrual health. If you have any concerns, don’t hesitate to reach out to a healthcare professional for advice.

Figure 1: FIGO Abnormal Uterine Bleeding (AUB) System 1, defining the nomenclature and definition of AUB (30). *The normal range is age dependent, with shortest to longest days for 18–25 years at ≤9 days, 26–41 years at ≤7 days, and 42–45 years at ≤9 days.