IS MY PERIOD NORMAL? Understanding Your Menstrual Cycle If You’re Trying to Conceive More than 70% 11% 95% of women have or more of of U.S. women start irregular menstrual American women their periods by cycles as menopause suffer from age 16. approaches. endometriosis.1 10% 12% of U.S. women are of women have affected by PCOS trouble getting or (polycystic ovary staying pregnant.3 syndrome).2 Fortunately, your menstrual cycle can tell you a lot about your fertility if you know what to look for. TYPES OF MENSTRUAL CYCLES Only 15% of About Normal = women have 30% of women are fertile only during 21 to 35 days the “perfect” the “normal” fertility 28-day cycle. window—between days 10 and 17 of the menstrual cycle. Day 1 Period starts (aka menses) 27 28 1 2 26 3 25 4 24 5 Day 15-28 23 6 Day 2-14 Luteal phase; Follicular phase; progesterone** 22 WHAT’S NORMAL? 7 FSH released, (follicle- uterine lining 21 8 stimulating matures Give or take a few days, hormone) and a normal cycle looks like this: estrogen released, 20 9 ovulation* begins 19 10 18 11 17 12 16 15 14 13 *ovulation: the process of an ovum (egg) being released from the ovary; occurs 10-14 days before menses. **progesterone: a steroid hormone that tells the uterus to prepare for pregnancy At least 30% of women have an “irregular” cycle either short, long or inconsistent. Short = Long = < 21 days > 35 days May be a sign of: May be a sign of: Hormonal imbalance Hormonal imbalance Ovaries with fewer eggs Lack of ovulation Approach of menopause Other fertility issues Reduced fertility4 Increased risk of miscarriage SIGNS TO WATCH FOR Your menstrual cycle provides valuable clues about your body’s reproductive health. Here are some red flags to look for. Could mean: HEAVY Could result in: Hormonal imbalances BLEEDING Anemia Fibroids or polyps Difficulty getting pregnant Endometriosis Must change Increased risk of miscarriage Bleeding disorders pad/tampon every 1 to 3 hours Could mean: Could result in: Irregular ovulation PROLONGED Disruptions to the uterine Iron-deficiency anemia lining BLEEDING Difficulty getting pregnant Problems forming blood clots More than 7 days Increased risk of miscarriage Could mean: Could result in: Thyroid gland irregularities Elevated hormone levels, such IRREGULAR Problems with ovulation as prolactin and androgens CYCLE Difficulty getting pregnant PCOS Increased risk of miscarriage Diminished ovarian reserve Ovarian insufficiency Early signs of menopause Could mean: Could result in: Ovulation isn’t happening NEVER Underdeveloped uterus HAVING A Difficulty getting pregnant or vagina PERIOD without intervention Scar tissue inside the uterus Premature menopause Low BMI (body mass index) WHAT TO DO Understand your menstrual cycle and understand your fertility. If you are trying to conceive, consult with a fertility specialist if you’re experiencing any of these warning signs: “Red flags” and early warning signs mentioned above Abnormal periods Heavy or prolonged bleeding Irregular menstrual cycle More than 3 months between periods Under 35 and trying for more than 1 year to get pregnant Age 35 to 39 and trying for 6 months or longer to get pregnant Age 40 or older and trying for 3 months to get pregnant Get educated about what’s normal vs. abnormal. Knowledge can save you time and heartache if you’re struggling to conceive. 1.888.761.1967 http://www.ShadyGroveFertility.com/appointment Sources 1"Endometriosis." Womenshealth.gov. February 13, 2017. Accessed March 01, 2017. https://www.womenshealth.gov/a-z-topics/endometriosis. 2"Polycystic ovary syndrome." Office on Women's Health. Accessed March 01, 2017. https://www.womenshealth.gov/publications/our-publications/fact-sheet/polycystic-ovary-syndrome.html#a. 3"Infertility FAQs." Centers for Disease Control and Prevention. February 16, 2017. Accessed March 01, 2017. https://www.cdc.gov/reproductivehealth/infertility. 4Wise, Lauren A., Ellen M. Mikkelsen, Kenneth J. Rothman, Anders H. Riis, Henrik Toft Sørensen, Krista F. Huybrechts, and Elizabeth E. Hatch. "A Prospective Cohort Study of Menstrual Characteristics and Time to Pregnancy." American Journal of Epidemiology. June 30, 2011. Accessed March 01, 2017. https://academic.oup.com/aje/article/174/6/701/88882/A-Prospective-Cohort-Study-of-Menstrual.