MENSTRUATION MATTERS

To follow Alexandra Jacoby’s recent post about talking more about menstruation (especially about the things we’re not allowed to talk about), I’m finally going to write about something that has been bothering me for a long time. Here it is:

Why don’t we talk about the important variations in our menstrual cycles?

In puberty our periods are all over the place, sometimes light, sometimes heavy, sometimes crampy, sometimes not.

If we have babies and have vaginal birth, we can bleed on and off for over a month and it’s totally normal.

Even in a normal month, we can have spotting for a day in the middle of the month.

Sometimes our periods are shorter or longer than normal, seemingly for no reason. (Although there’s probably always a reason.)

Then you hit your late 30s and – boom! – your periods might get heavier, or come faster. I was at lunch the other day with a friend and we started talking about the “late 30s gush” (her phrase, I can’t take credit). How come nobody talks about that when it’s totally normal?

As you age, it’s normal for periods to get shorter or longer or heavier or lighter, and even to come at different times than they did before.

Some women have terrible cramps and PMS, some don’t have any pain or bloating or other signs.

Some women who use hormonal birth control methods (e.g., the Pill, the Patch, Depo, etc.) don’t even know what their “normal” periods would be like and, rather, get used to whatever normal is on that method. Some menopausal women don’t even know they’re officially menopausal since they’re still on birth control or another hormone therapy (thus, don’t know whether they would have had their last menstrual cycle by now).

What we think of as a “heavy” period in puberty is different from a “heavy” period in young adulthood or midlife. Our definition of “heavy bleeding” changes as we experience the variations in our own menstrual cycles.

Some people are comfortable with pads, some with tampons, and some with menstrual cups. Some use a combination of all three. All of us switch what we use across our life course.

The meanings of monthly menstruation are variable too. If you’re trying not to conceive, it is welcome. If you’re trying to conceive, it’s unwelcome. If you’re not thinking about fertility at all, you could be indifferent, positive or negative about your period when it comes. If you have a disability or you are older or younger you might feel very different about menstruation. Perhaps your culture allows you to rest during menstruation and that could be good or bad for you. Perhaps you hide it, perhaps you don’t, perhaps you don’t want it on vacation but you do want it before vacation. Perhaps you do want your heavy days on the weekend, perhaps they come in the middle of the week (or vice versa). Bottom line, every month we could all feel differently about it.
Some people hit menopause in the early 40s, some not until their late 50s or even early 60s. Yet still totally normal.

Even if you have a partial hysterectomy, you could still get signs of your monthly cycle even if you aren’t officially bleeding.

And our own “normal” (what we are accustomed to) inevitably changes as we go through our life course, and we are often caught off guard by the menstrual experiences we have (as Alexandra discusses in the blog post I mention above).

How come we don’t have more conversation about this, when ultimately it would help all of us?

About a year ago I was talking to my own nurse practitioner about this and she admitted it would have been helpful for her to know what variations to expect in her own cycle. She, too, would have like to know about how menstruation would vary over her life.

So, who wants to talk to me about menstrual variations? Who’s ready? I’m ready…

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