At LOLA, our mission is to provide this community with the resources you need to make empowered and informed decisions about your reproductive health. Whether you’re looking for information about natural period products, or expert advice on your irregular period, we’re here for you.
In that spirit (and in honor of Women’s Health Week) we recently asked our community to share the reproductive health questions that keep you up at night. We’re featuring those questions, along with answers from our team of medical experts, every day this week on our Instagram channel.
We’re ending our series on a high note with Dr. Navya Mysore. Dr. Mysore is a primary care physician and director at One Medical and she’s a LOLA fan favorite on our weekly Period Support Group. Click here to watch the full interview, or read on for highlights.
Q&A with Dr. Navya Mysore
It’s no surprise that given the topic today of how your period can tell you something about your overall health, that A LOT of people had questions about what it meant for their health to have an irregular period. I think a lot of people think they are alone in that experience — and it’s also one that can generate a lot of fear. Before we dive into specific questions, can you set the record straight on what is considered an irregular period?
Great question! There are two answers to this. If your cycle length, meaning the time between one cycle to the next is less than 21 days or longer than 35 days, that is considered irregular. Another definition is if your cycle length varies by more than 20 days from month to month.
Does a very unstable or irregular period mean that I have a bad immune system?
In the first half of your cycle, the follicular phase, it’s thought that our immunity is higher to ward off infection, while it’s lower in the second half of our cycle, called the luteal phase. This makes sense if you think of it in terms of pregnancy. Our bodies in the first half of our cycle are preparing to fertilize a possible embryo and are making sure our system is at its healthiest. In the second half of our cycle, once ovulation has occurred and there is a fertilized embryo, your body doesn’t want to reject that embryo so it lowers our defenses to not reject implantation. So an irregular period can shift how long your follicular and luteal phase last and that can affect your immune system. But these changes are often minor and typically don’t have a big impact on our overall health.
My period in quarantine is basically nonexistent. Does this mean anything? Is there a reason behind it?
I know sudden changes to your period can be super stressful, but I want you to know that you are not alone! Many of my patients right now have been having an irregular period and/or skipped their period entirely. There can be a few reasons for this: 1) if you are sick right now or recovering from an illness, your body can pause your period as it repairs; 2) increased stress while sheltering in place can also lead to irregular period; and 3) diet changes and new medications/supplements can also affect your period.
Does the color of my period blood mean anything? Recently my period has been starting off black.
Change in the color of your period blood is totally normal. The color change happens because of contact with air and oxygen that’s coming through your cervix. At the beginning of your period, the surface of your endometrial lining starts to shed. When it sheds, it can look dark in color and almost black. As your lining continues to shed at a quicker pace, there is less time for it to be in contact with oxygen and the color will be lighter and closer to a brighter red color.
I took birth control pills for about 10+ years and stopped taking them a little over 1 year ago. My periods were always regular before, however since I’ve stopped taking birth control I’ve had periods of regular cycles and periods of irregular cycles. Has this happened to other women and is there anything additional I should monitor/be concerned about? What should those coming off birth control be looking for? When should we be concerned?
Everyone reacts differently when coming off of birth control. The symptoms you can have are a result of the shift in hormones as you come off birth control and your natural production of hormones picks up. These changes can lead to a variety of symptoms including period irregularity.
For most women, this transition typically lasts for a month or two before their body finds a new hormonal balance. However, if your period remains irregular for more than two to three cycles I would recommend talking to your primary care doctor to investigate further.
When should a cyst worry me? How might cysts affect my menstrual cycle (or vice versa)?
If you’ve had an ultrasound and it shows one or two cysts in the ovaries, these may be luteal cysts and they are follicles that were released at ovulation but were not shed with your period and often remain in the ovary and can have a cyst-like appearance. They typically resolve with the next cycle, but in some cases can burst, which will lead you to have more pain on one side vs. the other for a few days.
However, if the ultrasound finds many cysts this can be a sign of polycystic ovarian syndrome which typically includes symptoms of an irregular or absent period, as well as possible increased hair growth, acne, and weight gain.
In both cases, you should talk to your primary care doctor or gynecologist.
Can my period tell me if I have a hormone imbalance? Are there other signs to look for for a hormone imbalance?
Great question! If you have one or two periods that are irregular and your cycle returns to normal, I wouldn’t say that is a hormone imbalance but perhaps a response to lifestyle changes. If your period is consistently irregular, then that might indicate a hormonal imbalance. Other symptoms that can indicate a hormonal imbalance include worsening acne before or after your period, hot flashes, vaginal dryness, diarrhea or constipation and major weight changes. If any of the changes are happening consistently I would reach out to your primary care provider.
What might be causing some of my periods to be heavier than others?
Typically, the pattern of our periods shift most in early adolescence, after a pregnancy or in perimenopause and menopause.
However, factors such as stress, but also changes in exercise level, travel, and new medications/supplements can lead to large shifts in period patterns. There is no specific rule as to how these factors can impact our period and this can vary from person to person.
What can your cervical discharge say about your menstrual health?
Cervical discharge changes are based on our estrogen-progesterone balance and where you are in your cycle.
At the beginning of your cycle or when you start your period, your estrogen levels are low so you should have little to no cervical discharge. Leading up to ovulation, your estrogen levels are rising and you may notice a creamier texture to your discharge which is typically an eggshell color. At ovulation, your discharge is usually at its peak in terms of volume and has a stickier, slippery texture and can be egg white in color. A day or two after ovulation, your estrogen levels drop and progesterone takes over. Here, your cervical discharge quickly lightens and for some, it can totally stop.
It’s important to note that there is a large variation in this pattern — some women produce more discharge and others less. This is not an abnormal reflection of your menstrual health. If you are having discharge that is different from your usual or if your discharge is green, grey or has a fishy odor to it, you may have a vaginal infection — in that case, I would reach out to your primary care provider to discuss your symptoms.
Do you have any period tracking advice or apps you would recommend? Why can it be helpful to track your period?
I think it’s always helpful to track your period. Even when you are on birth control, it can be helpful as a reminder to take your pill every day (if that is the form of birth control you are taking). It can also be a great way to start learning about your cycle and ovulation if you are thinking about family planning.
It is especially helpful if you are having irregular periods or something has changed in your cycle and you are not sure if the pattern is repeating itself. When I see patients with an irregular cycle, one of the first things I want to look at is their period pattern. This could be as simple as a pen and paper calendar or marking it in your calendar on your phone.
I like apps because you can also keep track of other symptoms, like your mood and energy. I personally use the Clue app but if there’s an app that has been working for you please continue to use it, as there are many good ones out there.
For more advice from Dr. Navya Mysore, find her on Instagram @dr.navyamysore or keep an eye out for her on LOLA’s Instagram in the near future.