“Is this normal?!”
Then we spoke with board-certified gynecologist Dr. Mary Jane Minkin, clinical professor of obstetrics, gynecology, and reproductive science at the Yale School of Medicine to get her expert responses on these questions.
And here’s what she had to say:
Why is the blood darker in the end of the period?
“That’s a really good question! Some of the darker blood that comes out has been hanging around the uterus for a while, so it’s older blood. But not to worry, because it’s perfectly common and healthy.”
Why exactly do my poop habits change around and during my period?
“I have a scientific answer for that. The uterus makes something called prostaglandins during the period. They are chemicals that are responsible for our menstrual cramps. They squeeze smooth muscles of uterus and intestines, which contracts muscles and changes your bowel habits. Some women are more sensitive to the prostaglandins they make. It also can cause nausea. Some people have sort of a trifecta: diarrhea, nausea, and cramps. The things that can help with prostaglandins are nonsteroidal anti-inflammatory drugs (Motrin, Aleve, etc.) are NSAIDs (Nonsteroidal Anti-inflammatory Drugs) — which block the making of more prostaglandins. If you’re getting a lot of cramps, use NSAIDs. The key thing about managing cramps is taking it early. Also, women who take birth control pills make less prostaglandins. When you ovulate, you make more prostaglandins.”
Why do I get so emotional when I’m on my period?
“There’s not a scientific answer for that, but there is something called PMDD (Premenstrual Dysphoric Disorder) which is ‘bad’ PMS. There is strict medical criteria for this. Basically, these are really bad symptoms of anxiety, food cravings, irritability, bloating, full breasts discomfort. These symptoms get worse right before the period. We do know the same things we use to treat depression work pretty well for PMDD; SSRI anti-depressants work well for it.”
When I wear a menstrual cup and I lay down, does the blood go back in?
“The answer is no, it will not go back up into the uterus. It stays in the cup.”
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Is it true that if you never get your period ever, you cannot get pregnant?
“That’s not true. It’s hard to imagine someone who has a uterus not getting a period ever. For example, if I have someone who reached the age of seventeen and doesn’t have a period, we usually evaluate the period medically. There are people who have certain genetic abnormalities which lead them to never get a period. Those women would not get pregnant.”
When I was growing up, I was told that leaving tampons in longer than four hours could open you up to risk of Toxic Shock Syndrome, but most girls I know sleep in tampons. Isn’t this a bad idea, and really dangerous?
“I would say four hours is overcautious. The magic number would be about 12 hours. We encourage women to change tampons a few times a day to practice good hygiene.”
What side effects can there be when you take your birth control packs back to back (skipping the placebo week)?
“It’s perfectly safe to do that. The one thing that happens to women often when they do that, they’ll get spotting or staining before they finish the second pack of pills. But it’s not medically dangerous.”
Can having sex throw off your cycle?
“It’s unlikely this would happen.”
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Why is it that sometimes I don’t get my period but still have the symptoms like cramping, bloating, and heightened emotions while using a contraceptive like an IUD?
“If it’s an IUD, they’re probably referring to Mirena. The symptoms are caused by ovulating, but the progestins in the IUD flattens out the lining of the uterus. There is no lining to be shed, but you make all the hormones from the ovaries so you do get those symptoms.”
Is it normal if sometimes there are big “jelly” clots during my period?
“It happens to many women, maybe most women, so it shouldn’t be a problem. But if it happens too much and you’re bleeding heavily, talk to your gynecologist.”
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Is it normal for your boobs to feel really sore when you are on your period? Mine always get really sore when I’m on it and I’m not sure if this is normal or not.
“It’s very common to have fibrocystic breast changes. One thing that contributes to this is caffeine. Try and decaffeinate yourself a bit and it will probably help. One thing I recommend to my patients is this: vitamin B6 (100–200 milligrams a day), vitamin E (200 units), and evening primrose oil (2 capsules; 500 units) per day. 60–70% of my patients feel better when taking this.”
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What causes the back pain?
“There are a couple of things going on. The prostaglandins can give you general achiness, and you can try Motrin or Aleve to help. Part of it can be pelvic congestion, which can cause back pain. The third possibility is that it could be endometriosis. If you’re in a lot of pain, it’s worth checking with your gynecologist.”
Is it normal for the labia to ache during menstruation?
“For some people it does. This is because your pelvic muscles are filled up with blood (pelvic congestion syndrome) and this occurs when you have more blood there, so you’d feel it in your labia.”
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How long after giving birth will my period start back up again?
“Breastfeeding tends to delay the onset of periods. There are some women who won’t get a period until after six months after breastfeeding, but it’s hard to predict. It’s different for every woman. Check in with your gynecologist if you still haven’t gotten it after six months and you’re not breastfeeding.
And just a side note: If you start having sex right after having a baby, pregnancy can make you much more fertile — even if you had a hard time getting pregnant in the first place.”
What do the different colors of period blood mean? (Dark red, blood red, light red, reddish pink). Do they represent hormone levels?
“The color that comes out may reflect how long the blood has been sitting in the uterus. It doesn’t reflect the hormone levels.”
Why do periods emit a funky smell, and how can you avoid smelling like it?
“Old blood does have a funny odor. The vagina normally is acidic. You want to have an acidic vagina! But blood’s pH is basic. The vagina becomes more basic when you’re on your period. Some can be related to the growth of some kinds of bacteria. When you’re finishing your period, you can help your vagina’s pH get back to it’s acidic state. RepHresh can be helpful because it helps lower your PH.”
(Dr. Minkin is a paid consultant for the company that makes RepHresh.)
Lately I have been getting migraine headaches at the beginning of each cycle. They knock me out worse than cramps do. Is this just a part of getting older or is this not normal?
“It’s not uncommon. Some women notice it when they get older. There are several different kinds of migraines. Some are hormonally related and some aren’t. Peri-menstrual migraines happen when there is a drop in your estrogen level. When you start your period, your estrogen level is low, and that drop can trigger migraine headaches. I treat patients with a little bit of estrogen. Also, women sometimes get migraines when they go off the pill.”
Why do we get weird food cravings with our periods?
“We don’t have a scientific answer for that. It’s part of this PMS/PMDD package. Food cravings happen. If you’re feeding your extreme sugar and salt cravings, you will feel worse. You want to be eating complex carbohydrates!”
Is it a red flag if all of a sudden your flow becomes more irregular and heavier then before?
“I wouldn’t say it’s a red flag, but for some reason you’re not ovulating as well. I would check in with your gynecologist. Stressors can make you get funky ovulation. Also, changing exercise habits or hormonal changes can contribute to irregular or heavier flows.”
Is having few periods (a handful a year) a sign of underlying illness? Aside from this, I’m healthy and the periods themselves are normal.
“I would say probably not, but it’s good to check in with your gynecologist.”
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If you have a specific question or concern about your period, don’t be afraid to ask your gynecologist! Open communication between both of you will help you get the answers you need.