So what is a GOOD bleed? What is a normal period?

I don't know about you, but when they did the period talk at school, they didn't explain much about what was normal and what was not.

My period actually started when I was 10 (!) so before any formal education. At that time, my mum was peri-menopausal after years of awful periods that would cripple her in pain. I was told it was normal to be in pain and normal for periods to be heavy. But is that true?

So here is a definition of 'normal' when it comes to a period:

• A menstrual cycle is not necessarily 28 days BUT anything less than 21 days or over 35 days is a potential issue and suggests there is an imbalance of hormones.
• Your bleed can last from 2-7 days but 3-5 is optimal.
• On average, you lose 50ml (3 tbsp) of blood. Less than 25ml is considered scanty and could indicate low oestrogen levels. Over 80ml is heavy and can indicate a number of issues, most of which centre around high oestrogen levels.
• There should be no large clots. Clots happen when the flow is very heavy or when the endometrium doesn't break down properly. A few small ones are normal but larger ones mean the anticoagulant doesn't have time to work.
• There should be NO or very minimal pain. Yes, you did read that right. If you cannot eliminate the pain with an ibuprofen, then there is something else happening. It could be that you need some vitamin and mineral supplements or that there is a gynecological issue that needs resolving. Food is a huge factor here in many ways. I have just written a free guide to eliminating period pain that I will be offering very soon so watch this space!
• Your period should have a clear start. If you have spotting for a few days and then this is indicative of low progesterone levels. Your bleed should either start immediately as real blood flow or at least after a day of spotting.
• Whatever the length of your cycle, your bleeds should be regular. One or two days variance is normal but if you really have no clue when your next bleed is due, it could suggest a few potential issues with your cycle, including PCOS, anovulatory cycles, low oestrogen or luteal phase defect to name a few.
• The colour can vary but if it's pale or pink it suggests low oestrogen.
• You shouldn't really experience any PMS symptoms, or at least they should be very mild. PMS (in terms of mood-swings or physical symptoms, like migraines, breast pain etc) can be indicative of mineral deficiencies or progesterone depletion.

Did you get taught all that at school? I certainly didn't!

If you're reading this and thinking "hmmm...", then please do get in touch with me and we can discuss things further.
Amy

If you are trying to conceive, are trying NOT to conceive by using cycle awareness or if you are delving into Menstrual Cycle Awareness coaching, it is more than helpful to know when you are actually ovulating.
Unfortunately, we are not born with a light that comes on when we ovulate and our signs are a lot more subtle than with other mammals. However, there are some clues that we can use.

1. Cervical mucus
2. Cervix height and texture
3. OPKs
4. Basal Body Temperature charting
5. Other indicators

Cervical Mucus
Okay, so mucus is not something we really want to think about but when we want to know about ovulation it is one of the easiest indicators that we are at that point in our cycle. Throughout the menstrual cycle, our cervical mucus changes in texture, quantity and colour. In the couple of days before ovulation, our cervical mucus changes to be a texture similar to egg-whites. If you touch it between two fingers, it is clear and slightly stretchy and gelatinous. You will notice that you are wetter in the few days around ovulation and it is at this time that you should assume that you are your most fertile. Most women have quite consistent cervical mucus changes around this time, however, some women do not. If that is the case, give me a call and we can sort that out! After ovulation, the consistency becomes thicker again and a stickier consistency. 

Cervix Height and Texture
Around ovulation, your cervix is higher up in your vagina. If you insert your fingers into your vagina at different points of your cycle, you will feel that it moves so that when you are bleeding it is lower down and mid-cycle it is higher up. It may be worth feeling for these changes every few days so you are aware of the difference for your body. As we nearer ovulation, the tip of the cervix is also much softer than at other points of the cycle. This is not a method to depend upon but it is helpful to use alongside other methods.

OPK Tests
Many women use OPK test strips to help to predict their cycle. These urine test strips test for LH hormones, which can be an indicator that ovulation is imminent. These are a good method, however they are not entirely accurate as they only indicate that ovulation MIGHT happen, not that it WILL happen. Many women experience positive tests only to find they didn't actually ovulate or they experience positive tests on random days in their cycle, which is confusing but indicates that the body has unsuccessfully tried to ovulate a few times. It still remains one of the better methods.

Basal Body Temperature Charting
This method of charting your temperature upon waking (see my other blog post) is a great way of CONFIRMING if ovulation has or has not occurred. It is a really useful tool to use alongside OPK tests or physical indicators. It also enables you to accurately look for patterns in your cycle and many women are able to establish a regular ovulation window.

Other Indicators
Some women experience ovulation pain, breast tenderness, headaches and even spotting around ovulation. More subtle indicators can include changes to their skin, hair or nails, increased libido or other mood changes. Menstrual Cycle Awareness charting can help you to really understand your body and your emotions at different points of your cycle so that you can learn what is 'normal' for you around this time.

Something to note: just because you've had a period, that doesn't mean that you have ovulated. There are other causes of a bleed, such a breakthrough bleeding, withdrawl bleeding or menstrual health issues. If you are trying to conceive and it isn't working, it is important you go to visit your GP and I strongly recommend seeking the advice of a coach like me to guide and advise you on all your options.

What is Basal Body Temperature Charting?
Basal Body Temperature charting (BBT) is a cheap, non-invasive way to monitor your menstrual cycle. It can be used to inform choices: it will give you more information so that you can decide your next steps in terms of medical interventions or investigations. In reflexology, we use it to best understand what is going on in your cycle so that we can adapt your treatment protocol accordingly.

Who should use this method?
It is suitable for all women who are interested in learning more about what is going on with their menstrual cycle, who are not using hormonal contraceptives. This may include women trying to conceive, women who are having issues with their periods (such as women with PCOS or irregular cycles), women towards the end of peri-menopause who may have long stretches between bleeds and want to have a better idea of when to expect another, women who expect that they are no longer having menstrual cycles and want to check.

What do you need?
You need a good quality digital thermometer with 2 decimal places. You can choose to chart the temperatures by hand using graph-paper but it is MUCH easier to use an APP. There are several out there but I recommend Fertility Friend, which is a free APP that you can use on your phone and your laptop. It’s by far the quickest and most efficient way to input your data and the APP will help you monitor and understand the results. Some women find that using Ovusense is easier and gets more accurate results, especially women who have broken sleep or who work shifts. Ovusense is a device that you wear overnight inside you like a tampon which records your temperatures through the night you get the most accurate result and directly feeds the information to the Ovusense APP. It takes away the element of human error and I have a discount code you can use if you think this option may be most suited to you.

How do you do it?!
If using Ovusense, then just follow the instructions in the manual. If using a digital thermometer, then make sure you have already downloaded an APP, such as Fertility Friend, onto your phone before you go to bed. Have your thermometer next to your bed such that you can reach out and grab it without getting up. You MUST follow the following rules to get an accurate result, otherwise your chart will be skewed:

• Record your temperature at EXACTLY THE SAME TIME every day. Set an alarm clock. You can always go back to sleep. Otherwise it will not be accurate and you will not get the information you need.
• Take your temperature after a minimum of 3 hrs consistent sleep. If you think you may have to wake up in the night and may be up with a toddler or to go to the loo in the 3 hrs before your alarm clock goes off then you will need to consider Ovusense.
• Take your temperature before you do anything else. Take it before you speak, drink or go for a wee. It has to be literally the first thing you do.

Once you have taken your temperature, record it in the APP.

Additional information for the APP.
There is the option to record other additional useful information into the APP. This gives a much more rounded picture of what is going on and will help the APP to identify ovulation much more accurately.
This could include information such as observations about cervical mucus (especially when it feels like egg whites), cramps, low mood, information from OPKs, spotting and when you have made love.

What does it tell me?
In a healthy cycle, there is a clear difference in the temperature of the follicular phase and the luteal phase, indicating a rise in progesterone due to ovulation. As such the graphs will show you if you have or haven’t ovulated. They cannot predict ovulation as they show you what has happened not what will happen BUT if you find that after 3 cycles you are ovulating on the same day then you can plan for this and ensure you make love in your ovulation window in the days leading up to ovulation. If there is no clear ovulation indicated then you have had what is called an anovulatory cycle, in that you have not ovulated. This is very useful information for any woman! The luteal phase needs to be 11-16 days in length if you are trying to conceive so this will give you information about this phase and you will be able to monitor the length of this phase and use it to inform you of your next steps in terms of seeking medical support. It will also tell you about the length of your follicular phase, which could again be a useful stepping-stone towards further medical investigation.
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