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.
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.
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