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Period issues are all too common, but it’s hard to know what’s normal and what warrants further investigation.

As much as they can be a massive pain (literally and metaphorically), our menstrual cycles are an important indicator of our overall health, and paying attention to them can alert us to what’s going on with our bodies. Being in sync with your cycle is undoubtedly a good thing, but do you know what to look out for, what’s normal and when to seek advice?

“Years of advertising showing women with tight white shorts rollerblading and having fun while on their periods, adverts promoting huge absorbencies, and more importantly the promotion of keeping quiet about issues has allowed myths and misinformation to take over from facts,” says Affi Parvizi-Wayne, founder of eco period care brand Freda.

With this in mind, we asked the experts for the period red flags (excuse the pun) that we should all be aware of. 

Heavy bleeding

It may sound counterintuitive, but you really shouldn’t be putting up with heavy blood loss every month. “The average loss of blood during a menstrual cycle is between 2.5 and 3 tablespoons,” explains Parvizi-Wayne. “If you’re consistently needing to use products with massive absorbency, you don’t have to just put up with it. Go to see your GP, as it could be caused by a number of issues, from uterine fibroids to endometriosis.”

Obviously, we’re all different, and over time we get to know what’s normal for us. Added to this, it can be really hard to tell how much blood you’re losing, so if you’re worried, watch for signs such as soaking through a period product every hour for several hours, or needing to change products in the middle of the night. 

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Irregular bleeding

“Any vaginal bleeding between your periods should be checked out,” says nutritional and women’s health expert Thalia Pellegrini. “Day one of your period counts as the first day of your bleed. Ongoing spotting may be a sign of hormonal imbalance and is worth looking into, especially if you’ve noticed it over a number of cycles.”

Parvizi-Wayne agrees that spotting during your cycle should always be investigated. “Irregular bleeding could also be causing symptoms usually associated with PMS such as mood swings, headaches and tiredness,” she says. 

No periods

The absence of periods, known as amenorrhea, is a cause for concern that you shouldn’t overlook. “Amenorrhea, which is defined as usually missing periods for more than three months or the absence of periods, should never be ignored,” warns Parvizi-Wayne. “We need periods for our bone health, among other things. No periods or irregular periods are a sign that your levels of oestrogen are off – a hormone which is essential for healthy bones.”

It can also be a sign of stress, low weight or over-exercising, so pay attention to those cues and get to know what is normal for you. 

Late periods

“Obviously ruling out pregnancy, consistently late periods are a red flag,” says Parvizi-Wayne. “You might want to get your thyroid checked, especially if your late periods are accompanied by low moods, tiredness and weight gain.”

Long periods

Usually, we expect our bleeding to last around three to five days. According to Flo Health, if you are bleeding for eight or more days, and your volume of blood loss seems to be more than 80ml (about 5 tablespoons), it’s considered “heavy menstrual bleeding”.

Prolonged bleeding is also often heavier than usual, and the possible causes are similar to those mentioned above, from hormone imbalances to polyps or endometriosis, among others. If you’re worried, always speak to your GP – you really don’t have to suffer in silence. 

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Painful periods

Is there any other type? Well, there are actually two different categories of painful periods.

The first one, known as primary dysmenorrhea, “is the common menstrual cramps which happen with every or most cycles,” explains Parvizi-Wayne. “Pain starts one or two days before menstruation, lasting around three days and is accompanied by other symptoms like diarrhoea, sickness and vomiting.”

Secondary dysmenorrhea usually starts earlier in the cycle and lasts longer, but with no symptoms of nausea, tiredness or diarrhoea. “This could indicate the possibility of endometriosis, fibroids or pelvic inflammatory disease (PID), which is an infection caused by bacteria in the uterus,” says Parvizi-Wayne. “If you have severe cramps that last for more than two or three days, check with your GP to rule anything else out.”

Changes in menstrual cycle

Your mum is right – you should keep a record of your cycle. Parvizi-Wayne recommends noting “when your bleeding starts and ends and include the amount of flow and other symptoms such as spotting and the level of pain throughout your cycle”.

And remember, your menstrual cycle is more than just your period. According to Flo Health, “The menstrual cycle is a sequence of hormonal events (including ovulation) that prepares the body for a potential pregnancy approximately once a month,” while your period simply refers to the days you bleed.

In menstrual health terms, it’s important to know what’s going on for you for the whole 28 days (or so) each month, and not just the three to five days of bleeding. Then if you do have any issues, you can present your GP will all the information they will need to make a diagnosis or assess your needs.

Hopefully, the days when a woman visited a GP and was packed on her way with a prescription for the pill or strong painkillers are long gone, but as with so many other things, knowledge is power so if nothing else, make sure you know your body and what feels right and normal for you. If anything changes, always seek medical advice. 

Images: Getty

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