Menstrual health is often dismissed as “women’s issues,” yet clinicians increasingly treat the menstrual cycle as a vital sign — a monthly report on hormonal balance, metabolic health, stress, and underlying disease. When cycles change, the body is usually communicating something important.

A healthy menstrual cycle varies between individuals, but consistency matters. Regular cycles typically occur every 21–35 days, with bleeding lasting 2–7 days. Variations can be normal — but persistent changes are signals worth investigating.

What a healthy cycle commonly includes

• Predictable timing month to month
• Bleeding that does not interfere with daily life
• Manageable cramps that respond to simple measures
• No significant symptoms between periods

Symptoms that are often normalised — but should not be

Many women are told that pain, heavy bleeding, or missed periods are “just how it is.” Medicine disagrees when symptoms are severe, persistent, or worsening.

• Heavy bleeding: soaking through pads/tampons every 1–2 hours, passing large clots, or bleeding longer than 7 days.
• Severe pain: pain that prevents work/school or requires repeated strong medication.
• Irregular cycles: frequent missed periods or cycles shorter than 21 days.
• Bleeding between periods: especially if recurrent.

What clinicians investigate when cycles are abnormal

Menstrual changes can reflect hormonal imbalance, thyroid disease, polycystic ovary syndrome (PCOS), fibroids, endometriosis, stress, weight changes, pregnancy complications, or bleeding disorders. Investigation is tailored to symptoms, age, and risk profile.

Why ignoring symptoms delays diagnosis

Conditions like fibroids and endometriosis often progress silently. Early assessment can reduce years of pain, anaemia, fertility challenges, and mental distress.

When to seek care urgently

• Bleeding so heavy it causes dizziness or fainting
• Severe pelvic pain with fever or vomiting
• Bleeding in pregnancy

Bottom line: Periods are data. When the pattern changes, listen early. Investigation is not overreaction — it is preventive care.