When that ultra-fun time of the month comes, we know the drill…or do we? Sometimes our reproductive system has different ideas. It can be hard to tell whether or not our vagina’s just doing its thing, or whether something is actually wrong. It’s better to be safe than sorry so we sat down with a gynecologist to try and decode our cycles.
If you’re dizzy…
One of the top searches related to periods -- behind “periods suck” of course -- is dizziness. Dr. Julie Chor, a gynecologist at the University of Chicago, says dizziness could indicates a couple of different things. It could be simply be the pain or discomfort of a period, or something more worrisome like too much blood loss. “Very bad pain can make you lightheaded because it triggers an automatic physiological response.” Dr. Chor says. “The bigger concern is if women are having very heavy periods to the point where they could be anemic.”
This of course begs the question: what’s too heavy? “There’s a cut-off as in a liquid amount, but that’s not user friendly. I’d say if you're soaking through a pad every one to two hours for two or more hours, that’s generally a sign you could be bleeding to the point where your blood count could become too low,” Dr. Chor says.
If you have blood clots…
While maybe some people envision menstrual blood as a smooth stream, as with everything about periods, it’s a little messier than that. Sometimes clumpy clots are just a part of the deal, but hopefully not too clumpy. “Your period is passing the lining of the uterus, so you may have some small clots, but quarter size or bigger clots are quite large and could represent more bleeding than what might be considered normal,” Dr. Chor says.
As mentioned earlier, too heavy of a flow can drop your blood count to levels that can begin to affect your health, in which case you might want to pay your doctor or gyno a visit.
If your side effects are changing…
Maybe you never used to relate to your friend skipping class for cramps, but now feel the pain every month. Should you be worried? Probably not. “The body changes over time, so symptoms associated with your period can also change,” Dr. Chor says. A change in itself may not be concerning, but progressively more and more bleeding or lightheadedness, severe mood changes, or feeling down with depression symptoms could indicate something more is happening and you might want to go see a doctor.”
Related: 5 Things Your Gynecologist Wishes You Knew
If you missed a period, but for sure are not pregnant…
Dr. Chor says some fluctuation in a cycle is normal, but if you normally have a regular flow, missing a period for months or being too late could mean something more. “In order for women to have a regular period, your brain, ovaries, and uterus have to be in sync. They communicate through hormones. Stress can affect these hormones and can, therefore, disrupt this communication.” Dr. Chor says.
Another more concerning cause could be polycystic ovarian syndrome, which causes constant high levels of hormone rather than the fluctuating levels associated with normal menstrual cycles. “Irregular bleeding or cycles, elevated androgens, like testosterone, which women also normally produce, or increased acne or facial hair, could indicate you have Polycystic ovarian syndrome.” Dr. Chor says. If you notice that you have this constellation of symptoms, you may want to make an appointment to see a women’s health care provider to discuss possible evaluation and management.
Dr. Chor also says women sometimes experience random, but totally healthy, anovulatory cycles, where the body just decides not to drop an egg that month. Certain methods of birth control, like IUDs, can also cause irregular periods.
If something smells…
Anyone with a period knows a certain *odor* comes with the territory. Things have scents, including blood and uterine lining.
“Odor is incredibly subjective. More often than not when women come with that concern everything is completely normal,” Dr. Chor says. “Sometimes that concern can be triggered by a partner saying something, but they have to be educated that the human body smells and menstrual blood can cause odors.”
She also says infections can cause a distinctly bad smell, so a fishy scent or a smell accompanied with green or yellow discharge, fever or pelvic pain means you might want to go see the doc.
If you’re spotting between periods…
Annoying? Yes. Dangerous? Probably not. Other than birth control, which seems to love messing with our cycle, other types of irritation can cause unwanted spotting.
“Sometimes certain types of infection, like bacterial vaginosis, a yeast infection or STDs can result in irritability of the cervix,” Dr. Chor says. “Sometimes it could also be for anatomic reasons, like polyps, which are like extra endometrial tissue along the uterine lining, that usually benign but can cause spotting in between.”
If you have weird discharge…
It’s not like our vaginas can produce the rainbow, but sometimes what we see isn’t what we’re expecting. But our vaginas, for the most part, know what they’re doing. “It’s completely normal to have vaginal discharge which is often your body way of cleaning itself out.” Dr. Chor says.
But why all the different colors? Red equals blood obvi, but what about everything else? Dr. Chor says before ovulation but after you bleed discharge is thin and clear, but after ovulation discharge becomes thicker and more white because of an increase in a hormone called progesterone. But she says yellow or green discharge with foul odor, itching or painful urination could indicate an infection, so it’s still good to take a peek every once and a while and confirm everything is A-OK.
Even though sometimes it may seem like our period is out to get us, most of the time (believe it or not) our menstruation is just follows biology. It’s still good to keep tabs of what’s up down-there and go to the doctor if something seriously seems off.