Your guide to periods and the menstrual cycle

Keeping track of your menstrual cycle and periods is important, as your cycle can tell you a lot about your general health. Irregularities in your cycle, though not always serious, can be an indication of a health issue, so knowing what’s normal for you is important to help you spot anything out of the ordinary.

In this blog, we detail what menstrual periods are, the stages of the menstrual cycle, common symptoms you may experience during your period, how to track your cycle, and when to see a medical professional about your periods.

What are menstrual periods?

For most women, the menstrual cycle is a monthly hormonal process that helps prepare the body for pregnancy.

The cycle is counted from the first day of one menstrual period (when you start bleeding) to the first day of the next period.

Your menstrual period is the start of this cycle and is the stage in which you menstruate.

Stages of the menstrual cycle

For an average 28 day cycle, the menstrual cycle is typically broken down into four main phases:

Menstruation (days 1-7)

This is the first phase for your menstrual cycle. During this time, if you have a uterus, you will experience bleeding from your vagina. This is because progesterone levels (the hormone responsible for preparing your uterus for a fertilised egg) drop when implantation doesn’t occur, causing the uterus lining (endometrium) to shed. Your menstruation will typically last for 5 to 7 days.

Menstrual periods typically begin for women at around 12 years old, however it can start earlier or later.

Follicular phase (days 1–13)

This phase overlaps with your period and continues until ovulation. During the beginning of this phase, your body will increase production of the follicle-stimulating hormone. This hormone helps stimulate the growth and maturation of ovarian follicles (fluid filled sacs containing immature eggs) in your ovaries. This means your body is preparing itself to create an egg ready for ovulation.

You may experience certain changes in your hormones during this time. Progesterone levels drop while oestrogen increases, thickening the uterus lining in preparation for ovulation and possible pregnancy.

Ovulation (day 14)

During this short phase, your egg is released. This is done so the egg is ready to be fertilised by a sperm, and it is released into the fallopian tube. The released egg is only viable for one day, the day of ovulation, before your body reabsorbs it.

Your hormones will change again, with oestrogen levels decreasing right after ovulation and progesterone beginning to rise again.

You may experience symptoms such as cervical discharge, a slight rise in body temperature, increased sex drive, light abdominal pain, and mood changes.

Luteal phase (days 15-28)

This phase of your cycle happens just after ovulation and continues until your next period starts and is usually about 12-16 days long in total. During this phase, your progesterone levels rise to help the body prepare for fertilisation by thickening your uterus lining.

If fertilisation doesn’t happen, i.e. if you don’t become pregnant, your progesterone and oestrogen levels will drop significantly, leading to menstruation again.

In general, a ‘normal’ cycle can range between 21-35 days, meaning the phases date ranges can shift slightly earlier or later for each individual.

If your cycle gap is shorter than 21 days or longer than 35 days, this is considered irregular. Although it is not always a cause for concern, it’s worth speaking to your GP to rule out any underlying problems.

Common period symptoms and how to manage them

Often, you will experience symptoms during your luteal phase in the week leading up to your period and during your menstrual period. You may experience slightly different symptoms during each phase.

Premenstrual syndrome (PMS) is the experience of developing the physical and emotional symptoms before menstruation due to changes in your body’s hormone levels.

You might typically experience PMS symptoms such as:

• Headaches
• Bloating
• Mood swings and feeling irritable 
• Spotty skin or acne
• Loss of libido (low sex drive)
• Breast tenderness

Symptoms you may also commonly experience before, during, or just after your period include:

• Abdominal cramps
• Fatigue
• Bowel issues
• Lower back pain
• Issues sleeping

Once menstruation starts, you will also experience bleeding from your vagina for 5 to 7 days alongside the symptoms above. These symptoms tend to stop once you have finished menstruating and may start again the week leading up to your next period.

If you experience any of these symptoms during other parts of your cycle, it’s advisable to visit a doctor to discuss your condition. This is because your symptoms could be a sign of a gynaecological concern or another health issue that may need to be investigated further.

How to track your period

Periods can be tracked in a number of ways, such as tracking apps, smart health devices, keeping a diary or a calendar of symptoms, or keeping tabs on your basal body temperature changes.

Tracking your menstrual cycle can help you understand your hormonal pattern, prepare for symptoms, plan activities, and spot changes that may need further investigation.

Keeping accurate records can also help your doctor diagnose and manage any gynaecological concerns you may have more effectively, including heavy periods, irregular periods, and severe menstrual cramps. 

When to speak to a healthcare professional about your menstrual periods or cycle

If you have any concerns about your menstrual periods, cycle, or general fertility, it’s best to visit a doctor to discuss your condition and symptoms further.

You should definitely visit a medical professional if you have:

Heavy bleeding or long periods

This can be if you are soaking through a pad or tampon every hour for several hours in a row or need double protection on your heaviest days, passing large clots, bleeding that lasts more than 7 days, or you have symptoms of anaemia (pale, lightheaded, tired).

Irregular, absent, or very frequent periods

You should visit if:

• Your periods are consistently less than about 21 days apart or more than 35 days apart
• Your cycle length jumps around a lot month to month (for example 21 days, then 35, then 28)
• You go three months or more without a period (and you are not pregnant, post‑menopausal, or on hormones that stop periods)
• You have fewer than nine periods in a year

Severe pain or other worrying symptoms

You should visit if:

• Period pain is severe, sudden, or getting worse, or stops you doing normal activities most months
• You have pain during sex, when peeing, or when opening your bowels, especially together with heavy or irregular bleeding
• You have a fever, unusual or smelly discharge, or burning when you urinate along with bleeding or pain

These symptoms can be a sign of common gynaecological conditions such as fibroids, endometriosis, polyendocrine metabolic ovarian syndrome (PMOS, formerly known as PCOS), fertility issues, an infection, or other pelvic problems.

Frequently asked questions

Can stress affect my period?

Yes, it can. Stress can disrupt hormone signalling and delay ovulation, which may lead to late or missed menstrual periods, or more noticeable period pain. 

Making sure you maintain good sleep, get regular movement and practise relaxation techniques can help steady your cycle.

Can I exercise during my period?

Gentle to moderate exercise can help reduce menstrual cramps and improve your mood and energy. Pick activities you enjoy and adjust intensity based on how you feel during the different phases of your menstrual cycle.

When should I worry about blood clots?

Small clots are normal during the heavier part of your flow. Large clots (for example, those bigger than a 50 pence piece) or frequent clots may be a sign of heavy periods and should be further investigated.

Will hormonal contraception stop my periods?

Some hormonal contraception methods reduce bleeding or stop it altogether, which is medically safe for most people who use these methods. A medical professional can explain what contraception options are available to you, what their benefits and potential side effects might be, and help you find the right option to match your preferences and health needs.

Private period and gynaecological care with Circle Health Group

If you are concerned about heavy and or irregular periods and want to investigate further, visit our expert gynaecologists at any one of our hospital sites today.

A consultation with an experienced gynaecologist is often the quickest and simplest way to diagnose what is causing the issue with your periods. They can also talk with you about the best treatment options for your specific situation and provide lifestyle management advice to help ease symptoms.

Book an appointment with one of our experienced specialists by either call us directly or use our online booking system.