Women’s pelvic conditions are some of the most frequent we treat at Rebalance Physical Therapy. Many women who come to see us may also be experiencing hormonal imbalance, though they may not be aware that they are. No matter what the reason that you are coming to see us—pelvic pain, painful sex, orthopedic problems with your hip or back, postpartum healing, vaginal issues with menopause—we often need to consider hormones when we evaluate them for musculoskeletal dysfunction. This is because hormones play a role in the efficiency of muscle and the health of connective tissue, nerve, and bones.
This is part one of a mini-series introduced last week to help better educate women, mothers, sisters, friends, daughters, and the men in our lives about female hormone function. This is the stuff we as women should have been taught in middle school and high school health class about our bodies. However you identify in gender, we hope this helps you better understand some of the cyclic events of female reproduction.
Let’s start at the beginning: your period.
Fun facts:
-
- Women menstruate about 400 times in their lifetime.
- Nearly 50% of girls don’t know what is happening when they get their first period.
- Only 27% of Ivy League college students studied in 2006 were able to correctly identify when a woman was fertile in her menstrual cycle.
Did you know that becoming familiar with your cycle can help you understand how it’s affecting your mood, energy, sleep, appetite, weight, focus, sex drive, hair, skin, and digestion?
If you are saying that you don’t get your period anymore, no worries. Whether you are cycling or not, your menstrual cycle history remains an important vital sign throughout life and also a predictor of symptoms that you might experience in menopause.
What is a healthy menstrual cycle?
There is no such thing as perfect when it comes to periods. A cycle that lasts 28 days every time like clockwork is not the normal. A healthy cycle is more like a range of normal rather than a few set points. Also, consider what a healthy “normal” looks like for you personally.
But back to the question, what is a healthy menstrual cycle?
Here is a guide to consider when you are evaluating your menstrual cycle. Consider these 5 characteristics to get an idea of a simple baseline. If your cycle falls outside of these ranges, it may be a sign that your hormones and menstrual cycle are out of balance.
- 1. Menstrual Cycle Length— average length 26-34 days. This can also vary with the seasons of our life.
-
-
- During teenage years, periods can range from anywhere 23 -90 days.
- In reproductive years (20-mid 40’s), they can range from 24-38 days with an average of 29 days.
- Perimenopause (the period before menopause) – 24 days to 3-4 months apart
- It is normal for your cycle to change patterns over the course of a year. They can vary from as much as 6 days from one month to another
-
- 2. Period Length—average 3-7 days
3. Amount of Bleeding— no more than 6 pads or tampons/day. The heaviest flow day is typically day 2 but this can vary.
4. Pain— no more than MILD cramping or pelvic tension. There should be no need for medications, hot water bottles, or other comfort measures. Though these things can be helpful if you do have symptoms, your period should be no more than mild cramping and pelvic tension. It should not cause more than MILD breast fullness and not breast pain, cysts, or cyclic lumps. It should not correlate with headaches or migraines. Mild symptoms are acceptable and normal but they should not be moderate or severe.
5. Mood— mild shifts in mood, level of desire for social connection, energy, sleep, and cravings are normal but they should not feel extreme, disruptive, or out of control to you.
If you are falling out of range with any of these parameters, it may be time to seek additional help and management. Management can come in many forms: a conversation with your doctor/practitioner, changes in diet, medication, testing, lifestyle changes, and even physical therapy and exercise modifications. Physical therapy can help with the management of period pain, which may be caused by pelvic or abdominal muscle tension. Exercise can also help with the management of mood and pain associated with your period.
We are sharing this information for one big reason: if you are not aware of what is considered normal, then it is difficult to determine if you should seek guidance or medical help. This information is meant to guide you towards better answers. Special thanks to Dr. Aviva Romm, MD for all of the information that she shares about hormones and women’s health. This information is adapted from her book Hormone Intelligence, which offers practical and conservative strategies to help manage, restore, and maintain hormonal balance.
Written by Stephanie Muntzer, MPT, PYT, RYT200, CPI, SFMA, FMSc
Reference
Romm, A (2021). Hormone Intelligence. The Complete Guide to Calming Hormone Chaos and Restoring Your Body’s Natural Blueprint for Well-Being. (1st edition). HarperOne.
