Menstruation: What it is, what’s normal and how to help to manage any pain

Do you remember when you first learned about periods? Maybe it was during a school sex-ed class, or your parents gave you “the talk”. 

What we learned originally wasn’t always helpful or true, especially when it comes to having a healthier menstrual cycle.

We spoke to Dr Bronwyn Hamilton, Obstetrician and Gynaecologist, to give us a short refresher on what menstruation is. She also offered some guidance about common unhelpful period myths and ways to have a more comfortable period. 

What is menstruation? 

Periods are a part of life for over half of the humans on this planet. This includes most women, plus non-binary and trans people who happen to have a uterus. Menstruation is just a more formal term for what happens when the lining of the uterus sheds and causes bleeding from the vagina. 

“Menstruation is part of your menstrual cycle. This is where your body goes through a series of changes, primarily hormonal, each month to prepare itself for pregnancy,” says Dr Bronwyn. 

Typically, if you’re not using combined hormonal contraceptives, ovulation can happen around midway through your menstrual cycle. It’s when an egg is released by your ovaries for potential fertilisation.

Dr Bronwyn says that if the egg doesn’t get fertilised, the female hormones oestrogen and progesterone levels drop. In response, your body starts shedding the lining of your uterus and your period begins.

What is a ‘normal’ menstrual cycle length?

“Menstrual cycle lengths vary depending on the person. It’s different for everyone,” says Dr Bronwyn.

Fluctuations and changes in cycle lengths are common. Your cycle starts on the first day of your period and ends the day before your next period.  If you’re an adult who is not using any form of hormonal contraceptive, menstrual cycle length is typically between 21-38 days. 

“If you’re worried that your periods are too frequent, like every couple of weeks or that they are too far apart, like every couple of months, speak with your doctor.  There might be some underlying issues there,” Dr Bronwyn says. 

Common period myths and misconceptions

There are some things we’ve been taught about periods that aren’t entirely true and are holding us back from having healthier, happier cycles.  It’s time for a little bit of period myth busting...

Period pain is just what happens, right?

Period pain is very common, but it doesn’t mean you have to put up with it.  The medical term for period pain is dysmenorrhea, and it comes in two forms:

• Primary dysmenorrhea: When there is no detectable condition causing your period pain, which is usually mild and self-limiting. 
• Secondary dysmenorrhea: When an underlying condition causes period pain, which is more likely to be severe or prolonged in nature. 

Book an appointment with your healthcare providers to help manage your period pain and check that no underlying conditions are causing it.

“It’s a good idea to speak to your doctor when your periods are really painful or if they’re interfering with your daily activities, whether it’s work or leisure. If you’re having more than one or two days of period pain that isn't relieved by simple, over-the-counter painkillers, get some medical advice,” says Dr Bronwyn. 

If you don’t have an underlying condition, Dr Bronwyn says prostaglandins are what causes period pains. Prosta-what-now I hear you say?!

“Prostaglandins are released when the lining of the uterus starts to break down. They are pain-inducing hormones that cause cramps, helping to push out some of the uterine lining,” she says.

Dr Bronwyn says that period cramps can feel like a very dull kind of ache that can radiate  over your body. “People commonly have lower back pain with their periods, as well as abdomen and thigh pain. Some women also experience  headaches due to the prostaglandins released by the uterus and drop in female hormones acting on the tiny blood vessels in your brain ,” she says.

Some people also experience pain and spotting mid-cycle. During ovulation, you actually have a small cyst that ruptures from your ovary when it releases an egg. When the cyst pops, you can feel a sharp pain in your lower belly.

You should avoid exercise during your period, right?

Dr Bronwyn says that exercising during your period, as well as regular exercise, can help people have less period pain. 

“Exercise is really important. Exercise during your period and throughout your cycle helps with period pain. There's a study that looks at women who exercise regularly, and they do have fewer issues with their periods, particularly with period pain,” she says.

Have you heard the myth that you shouldn’t have sex during your period?

Some people worry whether it is safe to have sex during their period. In general, there are no physical side effects to having consensual period sex when you:

• practice safer sex (taking measures to reduce your risk of getting or passing on a sexually transmitted infection) 
• use contraception to prevent unplanned pregnancy

In fact, Dr Bronwyn says it can even help with reducing period pain in some cases as endorphins are released during orgasm. 

What about the myth around not getting pregnant and period sex?

It is possible to get pregnant from having period sex. While it is less likely, it can still happen. Why? Ovulation could occur prematurely during that cycle, and sperm can survive for up to five days inside the female reproductive tract. There is never truly a ‘safe time’ in your cycle.

How to make your period more comfortable

Now that we’ve set the record straight on some common unhelpful period myths, let’s focus on what helps period pain so we can have a healthier cycle. Here’s some ways to make ‘that time of the month’ more comfortable. 

Dr Bronwyn’s recommendations for a healthier menstrual cycle include:

Regularly exercising throughout your period

• This can help reduce period pain and give you better sleep

Getting enough rest and relaxation 

• High-stress levels have been linked to painful periods – try some stress management techniques like mindfulness, yoga or exercise

Eating foods that make you feel better during menstruation 

• magnesium-rich foods like dark chocolate, nuts, seeds, avocado, green leafy vegetables and peanut butter can help with period pain
• carbohydrates like whole grains, cereals and bananas can help with serotonin levels to improve your mood
• incorporating more good fats into your diet like olive oil, avocado, oily fish (like salmon and sardines) may help to reduce prostaglandins 
• antioxidant-rich foods like brightly coloured fruits and vegetables can help to reduce inflammation 
• foods high in fibre like oatmeal, pears and apples might help in balancing your hormone levels 
• reducing caffeine can help with breast tenderness 
• avoid salt as it can increase swelling and water retention 
• drinking more water as it can help reduce bloating
• to look after yourself during your period by eating regular, nutrient-dense meals and avoiding junk foods high in sugar

Talking to your doctor about supplements 

• “Supplements such as vitamin B6, vitamin D, zinc, fish oil and magnesium have been shown to possibly help with period pain and mood issues during your periods. But talk to your doctor before starting any of these, just in case they’re not suitable or safe for your individual needs,” says Dr Bronwyn. 

Knowing more means healthier menstrual cycles

As they say, knowledge is power, which is certainly true when it comes to having healthier menstrual cycles. Being able to tell period fact from fiction means we can better advocate for our health. You don’t have to put up with period pain – speak to your healthcare provider about pain management options available to you. 

We can also start to practice doing things that can make our periods more comfortable. Such as exercising regularly, eating foods that make us feel better and being kinder to ourselves with more rest and relaxation. 

Related:

• Keep forgetting to take your medication? 6 ways to help get back on track
• Why you keep getting sick and what you can do about it

Dr Bronwyn Hamilton is a Specialist Obstetrician and Gynaecologist who brings a personalised, sensitive and caring approach to her work in low and high risk obstetrics and general gynaecology.

Reviewed by the healthylife Advisory Panel June 2021