Is Your Menstrual Cycle Healthy?
Your menstrual cycle can tell you a lot about your health as a woman.
When I work with women, their cycle is one of the first things I ask about. Is your period consistent? Are you ovulating? How heavy is your flow? Are you spotting? Do you have significant pain or PMS?
These patterns can give us clues about your hormones, nutrient status, stress response, thyroid and metabolic health, and what's happening elsewhere in the body.
That doesn't mean every weird period is a problem. Illness, travel, poor sleep or a particularly stressful month can temporarily affect your cycle.
I'm much more interested in menstrual cycle patterns, persistent symptoms and changes from your normal.
Here are some of the biggest things I pay attention to:
1. Your cycles are irregular
Despite what you might have heard, your cycle doesn't need to be exactly 28 days. What’s more important is consistency.
A woman who reliably gets her period every 30 days is very different from someone whose cycles are 26 days, then 38, then 52, then 29.
When cycle length changes significantly, ovulation is often what's moving around.
Irregular cycles can point toward delayed or inconsistent ovulation, which can be influenced by stress, under-eating, over-exercising, thyroid dysfunction, PMOS, metabolic health, coming off hormonal birth control, and perimenopause, among other factors.
The irregular cycle itself isn't the diagnosis, though. It's a clue that tells us where to look next.
2. You aren't consistently ovulating
Understanding whether you're actually ovulating (and when) can tell us a lot about what's happening hormonally.
A lot of women don't realize that having a period doesn't automatically mean you've ovulated. Cervical mucus, LH strips, basal body temperature, and properly timed progesterone testing can all give us clues about whether and when ovulation is happening.
Regular ovulation is an important part of women’s health throughout your reproductive years, not just something to pay attention to if you're TTC.
3. Your periods are extremely heavy
If you're regularly bleeding through pads or tampons very quickly, doubling up, waking at night to change products, passing large clots, or organizing your life around your bleeding – it’s important to investigate why.
Heavy bleeding can involve hormonal patterns, but it can also occur with fibroids, polyps, thyroid issues, certain medications, bleeding disorders, and other conditions.
It's also important to check iron and ferritin when bleeding is heavy. Losing significant blood every month can contribute to iron deficiency, which can show up as exhaustion, hair loss, weakness, and lightheadedness.
4. Your periods are extremely light (or disappear)
Very light periods can be a sign that something is off, especially if you're barely bleeding for a day or two, your period has become significantly lighter over time, or your cycles are becoming increasingly long or disappearing altogether.
One thing I look at closely in these cases is energy availability.
Chronically under-eating, exercising too intensely, significant weight loss, poor sleep, and high stress can all affect the resources your body has available for reproductive function.
There are other potential causes too (including PMOS, thyroid dysfunction, certain medications, and perimenopause) which is why a very light or missing period is a clue worth investigating rather than a diagnosis on its own.
5. You're regularly spotting
When spotting happens matters. A tiny amount around ovulation occasionally is very different from spotting for several days before every period, randomly throughout your cycle, after sex, or suddenly developing spotting when you've never experienced it before.
Spotting before your period is often associated with low progesterone, but that isn't always the case. Hormonal patterns are one possibility, but contraception, pregnancy, cervical irritation, polyps, fibroids, and infections can also cause spotting.
The best way to figure out what’s going on for you is to track the pattern: whether it's new, when it happens, how long it lasts, and how much you're bleeding.
6. Your period pain interferes with your life
We've normalized painful periods to an unbelievable degree.
Some mild cramping can happen – but being curled up in bed, missing work or school, vomiting, fainting, or needing pain medication just to function is different.
Common does not mean normal.
Severe menstrual pain can have several potential causes, including hormonal factors, inflammation, endometriosis, ovarian cysts, and other pelvic conditions.
It's important to investigate why this is happening rather than simply accepting it as part of having a period, because significant pain can be a sign of an underlying issue.
7. PMS takes over your life every month
Your hormones naturally fluctuate throughout your cycle, so you shouldn't expect to feel exactly the same every day.
However, feeling a little hungrier, more emotional, or lower energy before your period is very different from losing a week of your life every month to severe irritability, anxiety, depression, insomnia, migraines, breast tenderness, bloating, or intense cravings.
When PMS symptoms become that disruptive, we need to understand why.
The relationship between estrogen and progesterone can play a role, but so can stress, blood sugar regulation, thyroid function, nutrient status, sleep, and other lifestyle factors.
8. Something changes suddenly
One of the most useful things to know about your menstrual cycle is what your normal looks like.
If you've always had a predictable 30-day cycle and suddenly it's 40 days or your periods become much heavier or PMS seems to appear out of nowhere – pay attention to what else may have changed around the same time.
Maybe you've been sick or under more stress, changed your diet or exercise routine, started a new medication or birth control, had a baby, started or stopped breastfeeding, aren't sleeping well, or are entering perimenopause. All of these can affect what your cycle looks like.
Remember: your cycle doesn't exist in isolation from the rest of your body, which is exactly why changes in it can give us so much useful information about your health.
What to do if something seems off
Start by tracking. Pay attention to your cycle length, bleeding, spotting, PMS symptoms, and signs of ovulation over several cycles.
From there, your cycle patterns, other symptoms, and health history can help determine what actually makes sense to investigate – whether that's comprehensive bloodwork, thyroid/metabolic markers, reproductive hormones, more comprehensive hormone testing, gut testing, or nutrient status.
The goal isn't to run every lab possible. It's to gather the right information to understand what your cycle is telling us about your health.
If you've noticed some of these patterns in your own cycle and want help figuring out what’s going on, you can start here →
