There’s recently been a cultural shift in how we talk about women’s “personal” issues. Where there once was whispering and under-the-table discussion about periods, PMS, and menstrual cups, there’s now prominent celebrities discussing bleeding, breast tenderness, and mood swings on social media. Women are becoming open books in popular culture—but when they start talking about their hormonal problems with their conventional medical providers, they’re often left with feelings of frustration, a lack of options, and (in some cases) misinformation about how hormones are linked to their symptoms.

So how do you know what’s “normal” if your conventional doctor doesn’t answer all your questions? When it comes to your cycle, there are a few key points that you should keep track of:

1. Length of cycle: How long are you going between bleeding? Is it longer or shorter than 28 days? Longer than 34 days? Are you skipping months? These are important details to keep track of!
2. Amount of flow: Whether you keep track of (approximately) how many pads or tampons you use or what volume you bleed into your menstrual cup on your heaviest days, it’s vital information to determine how your hormones are working. If you’re changing a large or super tampon every few hours, that is considered heavy bleeding. On the flip side, if your flow is really light this can also be a clue that something is going on!
3. Consistency: Having small clots in your discharge can be normal for some women, but when those clots start to become similar in size or are larger than a quarter, it can indicate a hormonal problem.
4. Symptoms: Throughout the month, you can start to experience different symptoms depending on where your cycle is at. Around ovulation, your libido spikes. The week before your period, your breasts can swell. While some mild PMS symptoms can be normal, having such bad cramps that only high-dose ibuprofen can get you through your work day is not normal.

Once you’ve collected all this information for yourself, it’s easier to figure out if your symptoms fall on the normal scale. Respecting the fact that each woman’s cycle is unique, there are a few ranges that give us clues to what may be out of the ordinary:

1. Length of cycle: Cycles between 28-34 days in length are considered on the normal spectrum. If you going under 21 or over 35 days between bleeding, this could be a clue that your hormones are out of balance. Also, if your cycles are irregular, or you’re having mid-cycle spotting seek a hormonal expert!
2. Amount of flow: Again with the spectrum here, but a normal flow can be about 10 to 35 mL. You know you’re starting to get towards a heavy flow diagnosis if you’re getting up in the middle of the night to change your sanitary product, you’re having to change your products every hour, or you’re starting to get signs of anemia (iron is lost when you bleed!). From a numbers perspective, when you’re getting to around 80 mL per cycle (or about 8 soaked super tampons), you’ve hit the threshold for heavy flow.
3. Symptoms: At different parts of your cycle, you can experience different symptoms that are completely normal but none should be disruptive or debilitating to your life. Many women have concerns about their PMS symptoms such as really tender breasts, cramping, facial acne, and overwhelming mood swings, but think all those are just a normal part of being a woman. Periods shouldn’t be a struggle, so if yours is, seek out a hormonal expert!

Not sure if you fall on the normal spectrum? Schedule a free, 15-minute consult with hormonal expert, Dr. Cassie Wilder

Dr. Cassie Wilder

Dr. Cassie Wilder is a registered Naturopathic Medical Doctor (NMD) and founder of MIMC. Her passion is empowering her patients through education, understanding, and support through their healing journey. After graduating from Iowa State University with a Bachelors of Science in Kinesiology and Health, Dr. Wilder earned her Doctorate of Naturopathic Medicine from Southwest College of Naturopathic Medicine & Health Sciences, a fully accredited and nationally recognized institution in Phoenix, AZ. During her clinical training, she received extensive hands-on training with many leading experts in the field of functional medicine and developed a passion for treating hormonal imbalances, thyroid disorders, cardiovascular concerns, and adrenal fatigue.