What your cycle is actually trying to tell you

Most of us were taught roughly two things about our cycle: when it would arrive, and how to hide it. Almost nobody was taught to read it.

That is a shame, because it is one of the most useful pieces of information your body produces about itself — and doctors increasingly treat it that way.

It is considered a vital sign

ACOG has formally encouraged clinicians to treat the menstrual cycle as a vital sign, asking about its pattern the way they ask about blood pressure, because changes in it often show up before anything else does.

Which means noticing your own pattern is not obsessive. It is the same instinct as knowing your usual resting heart rate.

You do not need an app, a wearable, or a protocol. You need to know roughly what yours normally does, so you can tell when it stops doing it.

What counts as normal

• A cycle of 21 to 35 days, counted from the first day of one period to the first day of the next
• Bleeding for 2 to 7 days, usually heaviest in the first three
• Some variation month to month — a cycle is not a train timetable

Normal covers a wide range. Two women can both be entirely healthy with cycles four days apart in length. What matters more than hitting an average is what is usual for you.

The four parts, in plain terms

Your cycle is not one state with a bleed attached. It is a loop with distinct phases, and most of what women describe as "feeling off for no reason" maps onto it.

• Menstruation — the bleed itself. Energy is often lowest here, and that is physiology, not weakness
• The follicular phase, afterwards — oestrogen climbing, and for many women the stretch where everything feels most possible
• Ovulation, around the middle — a short window, sometimes with a twinge on one side or a change in cervical mucus
• The luteal phase, before the next bleed — progesterone rising then falling, and where most premenstrual symptoms live

Working with it rather than against it

You cannot schedule your life around your cycle, and anyone selling that idea has not met a toddler. But small things help.

Put the hard conversation, the big presentation, or the difficult errand in the week you tend to feel most capable, if you have any choice about the timing. Expect less of yourself in the days before a bleed and plan the freezer accordingly. That is not indulgence; it is the same planning you would do around anything else predictable.

What is worth mentioning to your doctor

• Bleeding heavily enough to soak through a pad or tampon every hour for several hours
• Bleeding for longer than 7 days
• Cycles consistently shorter than 21 days or longer than 35
• Bleeding between periods or after sex
• Periods that stop for three months or more when you are not pregnant
• Pain that stops you doing what you normally do, or that painkillers don't touch

Severe period pain in particular is worth raising rather than enduring. A great many women are told it is simply their lot, and a good number of them turn out to have something treatable.

A note on tracking

Writing down the first day of each bleed, for three or four months, in whatever you already use, gives your doctor more than most appointments start with.

You do not need to log your mood, your temperature and your symptoms unless you want to. The dates alone are the part that does the work.