Misconceptions of the Menstrual Cycle

By Georgie Kovacs, founder of Fempower Health

Only 5 years ago, saying the word "period" was controversial. In a recent conversation I had with author Dr. Lara Briden, she even shared the challenges in gaining approval for her book title—Period Repair Manual. Today, however, social media is flooded with stories about women’s cycles, over 100 apps promise to track your cycle to create awareness about your body (and fertility), and innovative products and services continue to be developed.

Why is it, then, that women are still dismissed by doctors and continue to share stories pleading to understand why they are struggling and hoping to find answers? Let’s dive into some of the misconceptions related to our menstrual cycles.

Misconception #1: It’s all about your period and it should be 28 days
In 2019, an important study was published in Nature, which observed 610,000 period cycles from 124,648 women from the UK, Sweden and the US, between the ages of 18 and 45, who had a BMI (body mass index) between 15 and 50. Using the Natural Cycles app, they discovered that the average length of a woman's menstrual cycle actually lasts 29.3 days, with 65 percent of cycles falling between 25 and 30 days in length.

What does this mean for you? This dispels the myth that you ovulate on day 14.  As a result, you need the right tools to understand your body.

Why is this important? Your cycle length, whether you ovulate, and when you ovulate can tell you a lot about your overall health and potentially predict your experience of perimenopause and menopause symptoms down the road. In fact, Dr. Briden shared in her book and on our podcast interview together that “ovulation is the main event of your menstrual cycle.” As women, we speak so much about the days we bleed and almost nothing the rest of our cycle. 

However, signs of overall health include the right hormone fluctuations for your age, getting a healthy period, and ovulating on a regular basis in your reproductive years.

Misconception #2: Whatever your experience is during your cycle is normal
While it is true that we don’t all experience a 28-day cycle, this does not mean that everything that happens within each cycle is normal. The Mayo Clinic shares these foundations regarding things you should monitor about your cycle:

  • End date. How long does your period typically last? Is it longer or shorter than usual?
  • Flow. Record the heaviness of your flow. Does it seem lighter or heavier than usual? How often do you need to change your sanitary protection? Have you passed any blood clots?
  • Abnormal bleeding. Are you bleeding in between periods?
  • Pain. Describe any pain associated with your period. Does the pain feel worse than usual?
  • Other changes. Have you experienced any changes in mood or behavior? Did anything new happen around the time of change in your periods?

When speaking to naturopaths and Eastern Medicine professionals, they often like to understand the color and consistency (e.g., blood clots) of your cycle in addition to the above, so be sure to notate it. However, your OBGYN typically does not look at your cycle in this way it is important to monitor your body and do your research.

Misconception #3: Getting your period means you ovulated
Ovulation occurs when the ovary releases an egg. However, not all cycles are ovulatory. The term for this is an anovulatory cycle, and they may occur more often than we realize. While research in this area is quite limited and the subject is only just starting to gain traction, one study that took place in Norway showed that anovulation occurred in over a third of participants with clinically normal menstrual cycles. You need sufficient levels of progesterone to ovulate, however, insufficient levels can lead to heavy bleeding, which many think is the menstrual cycle, but it is not. 

Should you be concerned? First, in this summary, it states that anovulation is not a disease but instead a sign. You can work with a health professional to understand the root cause. Anything that impacts the thyroid, adrenal, hypothalamus, and pituitary glands can impact ovulation. One of the conditions many discuss as associated with anovulatory cycles is PCOS, or polycystic ovarian syndrome. 

Misconception #4: Painful periods are normal
Women continue to share stories that they are dismissed about their painful periods and put on birth control without further discussion. Painful periods are also normalized because it could be what a relative experienced and, with limited data in women’s health, we rely on our experiences. We may even dismiss our symptoms because we have lived with them for so long that they become our normal.

But when is it time to see your doctor? As recommended by the Mayo Clinic, it's time to see a doctor when: 

  • Menstrual cramps disrupt your life every month
  • Your symptoms progressively worsen
  • You just started having severe menstrual cramps after age 25

Misconception #5: Birth control is the solution
Birth control has become an interesting topic. I’ve interviewed experts who advocate for birth control and not having periods at all as well as experts who are concerned about the use of birth control and caution whether to use them and which type to be on.

Dr. Jerilynn Prior has been studying women’s health since the 1970s. Her concern with hormonal birth control is it must disrupt normal reproductive function to be effective. As a result, her recommendation is a birth control type that does not disrupt ovulation and menstruation.

Birth control is your choice, but when making your choice, it is important to understand the pros and cons of birth control in advance so that you are making the right choice for you.  

What you Can Do
It is important to emphasize that a woman’s body is incredibly complex with hormone fluctuations throughout a given cycle, all with the intent to make a baby, whether you would like to have a child or not. Based on what I’ve seen in the community and through experts I have interviewed, here are key tips to understand your cycle and your health:

  • Take Good Notes on You:  Don’t underestimate your expertise. Track your cycle, sleep (how many hours, what time you got to bed, when you wake up), diet, mood, etc. and share trends with your doctor. For example, if you are having an issue, notate what makes you feel better or worse.
  • Prepare for Your Doctor Appointments: It is not only important to notate key themes you see as you track your body and health, but it is just as important to prepare questions to ask (more on this in future posts!) 
  • Find a Community: Each of us needs something different to support us in our health journey. However, you can’t underestimate the power of community. Whether you observe from afar or share and comment, find a support network if you are struggling to find answers. It will help you feel less alone, and you might learn a few tips that would apply to your situation.
  • Pause Before You Act on Something You Learn on Social Media: Yes, when something works, we want to scream from the rooftop and help our fellow women. However, our medical histories don’t come with our social media posts, which means you don’t have full context for why something worked. Take it as a tip to consider, talk to your doctor, and then decide if it is best for you.
About Author Georgie Kovacs and Fempower Health

Georgie Kovacs, is the founder of Fempower Health,
 a go-to resource for all things women health serving women, their providers, and companies looking to build/improve on products for women. She also hosts the Fempower Health Podcast, where she interviews experts to help women better understand how to navigate their health both day-to-day and in partnership with their providers. Her mission is to minimize the years many take to seek proper diagnosis and treatment.
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