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Is your period normal? Functional medicine hormonal testing, common issues and causes

Updated: Dec 7, 2023

Do you know if your period is normal? Do you know how much blood loss during your period is considered "heavy"?

In this video, Dr. Williams and Dr. Mary discuss menstrual irregularities, focusing on what constitutes a normal menstrual cycle, normal period, variations, potential causes of irregularities, and essential tests to consider for proper evaluation.

Understanding the Menstrual Cycle:

  • The menstrual cycle refers to the monthly hormone fluctuation in women that typically spans 24-35 days. The period, on the other hand, is the actual bleeding lasting 5 to 7 days. It is normal for a woman’s cycle to vary from cycle to cycle up to nine days.

Normal Blood Loss during Menstruation

  • Up to 80 mL (or 2.7 ounces) of blood loss is considered normal during menstruation. Putting it into perspective, this is about 2-3 average-sized menstrual cups or 16 regular tampons throughout the entire cycle.

Excessive Bleeding/ Heavy Cycles

  • Excessive bleeding is defined as soaking through a super pad or tampon in less than two hours. This may indicate a concern and is something that should be discussed with a doctor.

Menstrual Irregularities

  • Dysmenorrhea: Painful menstrual cycles. This has been shown to affect up to 50-90% of women and is often worsened by stress.

  • Amenorrhea: Absence or infrequent menstrual cycles. Causes include stress, under-eating, over-exercising, being underweight, and Polycystic Ovarian Syndrome (PCOS).

  • Menorrhagia: Heavy menstrual bleeding where blood loss is more than 80 mL or when your period lasts longer than eight days. This is often associated with conditions like endometriosis, fibroids, or polyps.

  • Endometriosis: Characterized by the growth of endometrial tissue outside the uterus, which leads to pain and irregular bleeding.

Factors Influencing Menstrual Irregularities

  • Various factors such as stress, exercise, diet, medications (steroids, blood thinners, etc.), IUDs, and hormonal contraceptives can impact menstrual regularity. Puberty and perimenopause are phases where irregular cycles are expected.

Diagnostic Tests for Hormonal Evaluation:

  • To diagnose menstrual irregularities, it is imperative to test hormones at the correct time of the month. Additionally, a full thyroid panel helps provide a comprehensive view. Dr. Williams tests her patients on the following days for each of these hormones:

    • Estradiol, FSH, LH: Day 3-5 of the cycle (Day 1 is the first day of a woman’s period)

    • Progesterone: day 19-21 of the cycle

    • Testosterone and other androgens can be tested on any day of the cycle

Understanding the normal menstrual cycle, potential irregularities, their causes, and the diagnostic procedures for evaluating hormonal balance is crucial for women's reproductive health.

Become a patient with Dr. Sarah Williams today:


The information in this blog is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images and information, contained on or available through this blog is for general information purposes only. Modrn med and Dr. Mary Pardee make no representation and assume no responsibility for the accuracy of information contained in or made available through this blog, and such information is subject to change without notice. This blog does not provide medical services, diagnosis or counsel. You are encouraged to confirm any information obtained from or through this email with other sources, and review all information regarding any medical condition or treatment with your physician. Never disregard professional medical advice or delay seeking medical treatment because of something you have read on or accessed through this information.

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