Every woman can attest to the fact that no two periods are alike. Some flows are heavy, others are light. Cramps can either be non-existent or make you feel like you're going to die in fetal position on the couch with a half-eaten pint of Ben & Jerry's in your hand. It's normal to experience an array of symptoms from one cycle to the next, but there are some PMS symptoms are actually period red flags, and these are the ones you can't mask with chocolate or a heated compress.
Because there are so many PMS symptoms we can experience, it can be difficult to differentiate feelings of "ugh" from "uh-oh." More often than not, a woman's body will undertake every kind of premenstrual ailment in the books, and the best way to decode insignificant from doctor-assitance-needed is to focus on the extremes. Too much or too little of anything is almost always a red flag.
Unsure whether or not what you're experiencing is worth a trip to the OBGYN? Here are a few red flags to look out for.
1. Severe Bleeding
For some, experiencing heavy bleeding is the norm, but there's a difference between a lot and overflow. The average woman releases anywhere from 4-12 teaspoons of blood per cycle, and goes through 3-6 tampons per day. Anything more than this, is a red flag.
Board-certified physician and author of BodyWise: Discovering Your Body's Intelligence for Lifelong Health and Healing told RedBook that severe bleeding that lasts longer than seven days can be a tell-tale sign of “fibroids (benign tumors in the uterus), hormonal imbalance (typically an abundance of estrogen and not enough progesterone), stress (which reduces progesterone), [or] thyroid dysfunction (typically hypothyroidism),” or a clotting disorder.
2. Not Enough Bleeding
Light cycles can feel like a total win (less mess, minimal cramping), but if your flow produces barely any blood, this could be concerning as well.
There are a few reasons why you may be experiencing light periods. Consider factors such as your body fat percentage (being underweight can cause irregularity), birth control, how often you exercise, and stress. If you're sexually active, and your period is less flowy and more spotty, there's a chance that you could be pregnant.
3. You're Experiencing Horrible Cramps and/or Other Physical Illness Like Vomiting or Fever
If you can honestly say you've never experienced the striking pain of what feels like a literal punch to the pelvis, I envy you.
Period cramps can feel like nature's way of punishing a woman for being born with a uterus, and while it's pretty normal to experience a decent amount of pain during that special time of month, your body's raising a red flag if it becomes overwhelming.
Prostaglandins, hormone-like material produced in the uterus, are the root of all cramps, and all the symptoms that trail close behind. Either your body is overproducing them, or you're experiencing sensitivity. Experts suggest taking over-the-counter medication such as Aleve or ibuprofen to ease the symptoms, but that doesn't work it's in your best interest to call the doctor.
4. Brown Spotting
Brown blood isn't necessarily bad blood, but it's definitely something to look out for.
If you find thick, dark blood sparsely appearing throughout your cycle, it's probably old blood that didn't make it out of the body from your previous cycle due to a sluggish menstrual flow or lack of urination.
If you're experiencing brown spotting before your period, however, this may be a sign of a minor injury to the cervix or infection.
Periods are sassy. They come and go when they please despite the every-28-days rule. In fact, it's normal to have consistently late or early periods. What's not normal is when knowing when an estimated time of arrival becomes a guessing game.
Sherry Ross, M.D. told Marie Claire that, generally, a woman's menstrual cycle will occur every 21 to 45 days, so if you've been waiting a month or so in between cycles, that's a huge, violently waving red flag.
The culprit? Stress, diet, and/or an intense workout routine all contribute to infrequent cycles, but it's best to consult your doctor as chances are you're at risk of a thyroid disease.
6. Missed Period Over the Course Of A Few Months
Once in a while your body may give you a pass and skip a period. This could be cause for celebration because, let's be honest, who wouldn't be thankful for a month off from mood swings and a sore pelvis, but it also could be an SOS waiting to be answered.
Stress, hormonal fluctuation, and low body fat are probably causes, but it might be worth a quick trip to the OBGYN to make sure it's not a situation of an over-active thyroid gland or ovarian tumor.
Just the idea of blood clumps is disturbing, but according to the Mayo Clinic, they can be pretty normal. It's when you start experiencing frequent, large blood clots, though, that raises an issue.
Passing large blood clots may be a sign that something's wrong. If your periods seem heavier than usual — for instance, soaking through one pad or tampon every hour for several hours or passing very large blood clots — check with your doctor.