When you’re trying to get pregnant, one of the first things you’ll probably start paying extra attention to, is your period. Because after all, it’s the ABSENCE of your period that’s usually the first tell-tale sign that you’re pregnant – and the reason that you’re likely to take a pregnancy test.
Of course, you probably already know that you NEED to be getting periods, and ideally getting them regularly, in order to get pregnant at all.
But what you might NOT know, is that your ability to get pregnant doesn’t just rely on having periods per se, it relies on having healthy periods and a healthy menstrual cycle. You might also be unaware that your periods themselves, can actually provide you with some really valuable clues about the state of your fertility and your chances of getting pregnant.
So in this article, I want to discuss what a healthy period and a healthy menstrual cycle looks like. I’ll also share the 9 signs to watch out for that can indicate a problem and that your fertility could be compromised.
But first, let’s do a quick ‘Period 101’, as a reminder of exactly what a period is, why we have them and how they relate to your fertility.
Period 101 – what exactly is a menstrual cycle?
Your menstrual cycle and your periods are critical for reproduction. Your menstrual cycle is the monthly event that allows your body to produce an egg and prepare for pregnancy. Without a menstrual cycle and periods, you can’t get pregnant.
Your menstrual cycle is counted from the first day of one period, until the day BEFORE your next period. It can be split into three parts or phases: the follicular phase, ovulation and the luteal phase.
All 3 of these menstrual cycle phases play a critical role in your ability to get pregnant. Let’s take a quick look at each one.
The follicular phase is the first phase of your menstrual cycle. It begins with the start of your period and ends at ovulation.
During the follicular phase, an egg grows and matures in one of your ovaries. The egg is contained within a kind of sac, known as a follicle. At ovulation, this follicle ruptures to release the egg from the ovary.
At the same time that your egg is developing, the lining of your uterus also grows and thickens, in preparation for supporting and nurturing an embryo.
During the follicular phase of the menstrual cycle, estrogen is the dominant reproductive hormone.
Ovulation is the second phase of your menstrual cycle. It occurs at the end of the follicular phase. This is the process where the mature egg bursts out of its follicle and is released from one of your ovaries. This event takes just a few minutes to a few hours to occur.
The best time to get pregnant is in the 2 – 3 days leading up to ovulation day. The day of ovulation is your last day of fertility.
The luteal phase is the third phase of your menstrual cycle. It begins after the release of your egg at ovulation, and ends the day before your next period begins.
If your egg has been fertilised by sperm, it travels from the top of your fallopian tube towards your uterus during this time. If your egg hasn’t been fertilised, it dies within 24 hours and is reabsorbed by your body.
At the same time, the lining of your uterus continues to develop in preparation for implantation of the fertilised egg.
The fertilised egg will implant into the uterus lining approximately 7 – 10 days after ovulation. This is known as implantation. In this case, your body will retain the lining of the uterus, so that it can support and nurture the growing embryo. And this, of course, is why you don’t get your period if you’ve conceived.
If you haven’t conceived, the lining of your uterus will be lost from your body as a period. This will occur 10 – 16 days after ovulation.
During the luteal phase of the menstrual cycle, progesterone is the dominant reproductive hormone.
Your periods and your fertility health
Your menstrual cycle and your periods are a reflection of your reproductive and fertility health. Your menstrual cycle is orchestrated by a delicate balance of reproductive hormones. If your hormones are out of whack, this can affect your follicular phase, ovulation and your luteal phase in a number of ways. Likewise, certain medical conditions and lifestyle factors such as stress and lack of nutrition can also impact your cycle.
So what SHOULD a healthy period and a healthy menstrual cycle look like?
Here’s my 8 point ‘Healthy Period Checklist’ that I like to use with my clients:
1. Period length
Your period should be between 2 and 7 days long, with most of the bleeding occurring in the first 2 to 4 days.
2. Bleeding or spotting between periods
You should have no more than a day of spotting before your period starts or 2 – 3 days of spotting at the end of your period. Apart from 1 – 2 days of spotting around the time of ovulation, there should be no bleeding or spotting at any other time during your cycle.
3. Blood loss
The amount of blood that’s lost during a period can vary considerably from woman to woman. Anywhere between 25 mls and 80 mls (about 1.5 to 5 tablespoons) is considered normal. This equates to saturating about 5 -16 regular tampons or pads or 3 – 8 super tampons or pads over the whole time that you have your period.
Your period blood should be reddish-brown in colour. The colour will vary depending on how slow or fast your flow is. Blood turns a brown colour when it’s exposed to air, so the slower it flows, the browner the colour. Faster flowing blood is typically bright red.
Your period should be mostly liquid. However, it’s perfectly normal to see some small blood clots, mucus or little bits of uterus lining along with the blood. Blood clots are gel-like blobs of coagulated blood that usually occur when your flow is heavy. They shouldn’t be any bigger than about 1.8cm (0.7 inches) in diameter and there should only be a few.
6. Menstrual cycle length
Your menstrual cycle is counted from the first day your period starts (proper blood flow, not just spotting) through to the day before your next period starts.
A normal, healthy menstrual cycle can be anything from 21 to 35 days in length (although cycles shorter than 24 days can sometimes indicate a problem). Ideally, your cycles should be regular and around the same length each cycle. Some minor variation is completely normal.
It’s normal to have some minor PMS symptoms in the few days leading up to your period, such as mild bloating, cramping, acne and irritability or moodiness. Ideally, apart from these minor symptoms, your period should just ‘arrive’ without you noticing much at all beforehand.
8. Pelvic pain
Some mild abdominal or lower back pain just before and during your period is normal. Likewise some mild abdominal pain or twinges (especially on one side) around the time of ovulation is also normal. Severe or ongoing pain is not and may be a symptom of endometriosis.
Do you have healthy periods?
If you can tick off these 8 checkpoints, you can feel confident that your menstrual health is in good order. And that means your fertility health probably is too.
Having said that, it IS possible to have what appears to be a perfectly normal menstrual cycle, but still have an underlying fertility problem. The most common example of this is a luteal phase defect.
Learning fertility awareness and charting your fertility is a great way to discover if your menstrual cycle and periods are normal. It can also help uncover issues such as a luteal phase defect and other more subtle abnormalities.
So when should you be concerned? When should you book an appointment to see your doctor or OBGYN?
Signs of a problem
If you experience any of the following, especially if you’re having difficulty getting pregnant, it’s important that you see your doctor. The symptoms below can be a sign of conditions that not only affect your menstrual health, but that can also affect your fertility and your chances of getting pregnant.
- No periods or very irregular periods
- A cycle length of less than 21 days or more than 35 days
- Spotting for 2 or more days before your period starts
- Bleeding that lasts for less than 2 days or for longer than 7 days
- Heavy bleeding – losing more than 80 mls of blood (or soaking more than 16 sanitary products)
- Spotting or bleeding that occurs at times other than during your period or around ovulation
- Large or frequent blood clots
- Extremely painful periods or pelvic/lower back pain between periods
- Extreme PMS
If you’ve been charting your fertility, or keeping a record on an app, take this information with you, as it can help your doctor see exactly how and when your symptoms are occurring.
Some doctors aren’t familiar with what’s normal and healthy and what’s not when it comes to menstrual cycles and periods. If you don’t feel your concerns are being taken seriously or that you’re getting the care you need, I highly recommend that you get a second (or third!) opinion, or ask to see a specialist.
Keep an eye on your periods
A healthy menstrual cycle and healthy periods are the foundation of your fertility. So it makes sense to keep an eye on your periods when you’re trying to conceive.
Being aware of signs and symptoms that can indicate a problem is incredibly valuable. If you’re not getting pregnant, these symptoms can help you and your doctor figure out where the problem might lie.
In my Fast Track to Pregnancy Program™ I show you step by step, how to recognise if you have a problem with your periods or your menstrual cycles. I also discuss the possible causes and what you can DO about it.
Need help? Feel free to book a fertility consultation with me here.