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Let's talk about that time of the month. Your menstrual cycle aka Period.

Updated: Nov 2, 2021

This is a topic that we should talk about more openly. From a young age females menstrual cycle begins, aka your ‘period’. With little information provided and it often seen as a taboo topic, it is hard to know what is normal and what is not. For most females we will get a period about 500 times over our lifetime.

From initial onset of our period, it can take a few years for our bodies to settle into a routine, while at the other end of our reproductive years, changes to our period is often the first sign of menopause.

Contributing factors such as stress, medical conditions and exercise/diet and you may see changes in your period as well.

When you come into clinic for a women’s health session, we discuss your menstrual cycle in depth, during this conversation we ask about your cycle. We ask questions such as:

🩸 How long it lasts?

🩸 How much blood you lose?

🩸 Whether you feel any aches or pains?

🩸 Do you use tampons or the menstrual cup, if so, have you experienced pain inserting one?

🩸 Any spotting, clots, or abnormal discharge?

🩸 What age were you at the onset of your menstrual cycle and what was it like?

🩸 Has your menstrual cycle changed?

🩸 Do you have pain with opening your bowels usually or with your menstrual cycle?

🩸 Do you have any chronic conditions such as endometriosis, adenomyosis &/or PCOS?

As a women’s health Physiotherapy, we can assist in:

  • Navigating your period ~ what is normal and what is not

  • Managing your pain ~did you know that an internal hip muscle and/or pelvic floor muscles can refer to the lower abdomen and this may be the pain you are experiencing? This may be treated through use of internal and external releases, TENS machine, exercises & stretches.

  • If you wish to use tampons/menstrual cup but are having difficulties, we can investigate why you may be and assist if treatment strategies ~Maybe you have a tight pelvic floor

  • Education around bowel habits and toilet positioning

Of course, there is so much more which is personalised to your signs and symptoms.


We recommend keeping a diary of your menstrual cycle. There are some great apps that help you track your cycle too!

What is a ‘Normal’ Period?

‘Normal’ varies for each female. Let’s start with what your menstrual cycle is. The beginning of your menstrual cycle is the day you begin to bleed, what we call our period. This occurs when the uterus (womb) gets rid of its lining. This occurs every month in preparation for pregnancy, if there is no pregnancy it repeats and the uterus sheds its lining again.


🩸 The average length of a menstrual cycle is about 29 days, however it can be as short as 21days or as long as 35.

🩸 As a guide most of the time spent bleeding is between 3 to 7 days

🩸 The heaviest flow occurs in the first 1 to 2 days

🩸 For some women the period can last up to 1 week, others may only have spotting rather than flow on their first day.

🩸 The amount of blood lost can vary from between 20ml (1 tablespoon) and 90ml (1/3cup), this means that you should be able to go three or more hours prior to changing your pad or tampon. At night time you should not need to change it.

🩸 Losing more then 80ml is classified as a heavy period.

As per the image, If you do experience period pain, that is NOT considered normal we recommend speaking to your healthcare professional and getting it further investigated. 👩‍⚕️🧑‍👨‍⚕️

Painful periods can be caused by several things including:

💥 Endometriosis – Chronic condition affecting 1 in 9 women in Australia, it occurs when cells like those that line the uterus grow in other parts of the pelvis. For more information scroll down for multiple posts covering all things Endo!

💥 Adenomyosis: Chronic condition in which cells like those that line the uterus also grow in the muscle wall of the uterus.

💥 Fibroids: Benign tumours made of muscle and tissue that grow in the uterus.

💥 Pelvic Infections

Sometimes periods are not painful but irregular. On average women should experience 4 periods per year. Irregular periods may be due to:

☁️ Stress, Underweight, Eating disorders or excessive exercise

☁️ Contraception

☁️ Pregnancy &miscarriage

☁️ Polycystic Ovary Syndrome (PCOS) – A complex hormone disorder

☁️ Thyroid disorders & chronic diseases (kidneys)

☁️ Approach of menopause


Premenstrual Syndrome, aka PMS is a broad range of physical and emotional

symptoms experienced by women in the days leading up to their period. Up to 90% of women experience at least one symptoms most months, 50% experience several. Symptoms can start anywhere between 4-10days before menstruation and often resolve once bleeding begins.

Symptoms can include:

• Bloating

• Fluid Retention

• Breast Swelling & tenderness

• Headaches

• Skin problems

• Lethargy

• Constipation &/or diarrhoea

• Mood changes

Premenstrual Dysphoric Disorder aka PMDD. Along with physical premenstrual symptoms, between 3-8% of women experience debilitating mood or psychological symptoms, particularly depressive symptoms, and irritability. PMDD can interfere with and impact a woman’s life significantly. As per PMS, PMDD symptoms get significantly better when bleeding begins.

The cause of PMS & PPMDD is due to an increased sensitivity to hormones in the lead up to menstruation, largely genetic and can occur post early childhood trauma, after having a baby or closer to menopause. This is caused by an interaction between hormones from the ovaries and brain neurotransmitters, which influence mood.

There are many lifestyle, natural and medical therapies available that can help manage PMS & PMDD. You don’t have to suffer in silence. Natural remedies such as regular physical activity, using alcohol sensibly, reducing stress, avoiding smoking and maintaining a healthy weight can all make a difference. Vitamin B6 (between 100-200mg) has been shown to make a difference. Chaste tree (aka cherry berry and vitex angus castus) can reduce mood swings and irritability. Other lower evidence supplements include lemon balm, magnesium and calcium.

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