Repetitive strain injury (RSI)

How do you know if your periods are normal? Well, it’s really difficult because we’re all different and we all experience different periods. But I’m joined today by Dr Sam Wild, who’s Bupa’s Clinical Lead for Women’s Health, and we’re going to share a few tips on what to look out for to identify when something might not be quite right.

So, Sam, let’s start off. What should period blood look and smell like?

At the start of a period, you might notice that your period blood is a light pink colour. That’s because the blood mixes with the cervical mucus that’s there, so pink is normal. Bright red is when the blood is flowing at its fastest and leaving the body quite quickly, usually from the start to the middle of the period. It can then turn a darker red-brown or even look quite black. That’s a sign that the blood has taken a little longer to leave the body as the flow has slowed down. It has come into contact with air and oxygen, which makes the colour change.

All of those colours are completely normal. Orange, yellow or grey can be a sign of infection, so if you notice anything like that, you should speak to your doctor. Blood smells a bit metallic; you’ll know that if you’ve ever cut yourself. But if it has a really offensive odour, particularly if you also have itching or soreness, I would definitely recommend that you see a GP. Again, it might be a sign of infection or something else going on.

What about the heaviness and flow of periods? How heavy is too heavy?

There are lots of different things you can look out for here. If you’re changing your pad or tampon more frequently than every one to two hours, that can be a sign that your period is quite heavy. If you need to use two products together—for example, a tampon and a pad, or two pads—that could also be a sign. Flooding through to your bedding at night or leaking into your clothes during the day is another sign. It’s normal to pass some small clots, but if they’re bigger than, say, a 10p piece, I would recommend speaking to your doctor.

Okay. And there’s something around quality of life, isn’t there? For example, if it’s stopping you from going to work or school, or doing the things you would normally want to do.

Exactly. If you’re feeling really tired or short of breath, that could be a sign that you’re anaemic. So, in those situations, go and speak to your GP.

And what sort of conditions might cause very heavy bleeding?

A very common one is fibroids. These are benign growths of the uterus, or womb, which can cause heavier bleeding. Endometriosis and polycystic ovary syndrome are also very common. There are other conditions too, such as an underactive thyroid, and plenty of other things that the GP will be trying to exclude.

Okay. What about period pain? Period pain is normal to some extent, and most of us experience it, but when is it too much?

Yes, as you said, period pain is normal. The uterus contracts to make the lining leave the body, which is what we see as a period. But if it’s stopping you from doing your normal daily activities, or you’re losing time from school or work, that isn’t normal. So it’s very simple, really: if it’s stopping you in your tracks, go and see your doctor.

And people can try things like paracetamol and ibuprofen, which tend to be helpful for most people, don’t they?

But if you’ve tried those and it’s still making you miserable, stomach massage and exercise can also help. If that isn’t enough, do go and seek some help.

And finally, what about how our menstrual cycle affects our emotions? Is it normal to feel up and down and all over the place?

It absolutely is, because our hormones change throughout the month. In the first half of our cycle, as oestrogen levels rise, that’s when we feel our best and most energetic. Then, in the second half of the cycle, as progesterone levels rise, we can feel quite slowed down and low. That usually continues into the first part of your period too. These are what we call premenstrual symptoms, and they’re absolutely normal. But if you find that they’re affecting your life and you’re unable to carry on as normal, you must seek some advice.

Yes, because there are things your GP can do to advise and support you, and help alleviate some of these symptoms, aren’t there?

There are. Lots of medications can be tried, so it’s definitely worth going to have a chat with them.

Thanks, Sam. You’ve highlighted four key areas where people can look out for signs that something isn’t quite right: the look and smell of the blood, how heavy the period is, how much pain there is, and how it affects mood. I think the final thing to say is that you know your body better than anyone else. So, if something has changed or you’re not happy, get it checked out by your GP.