Should your Menstrual be the 5th Vital Sign? What does a Healthy Menstrual look like?

What if your menstrual cycle isn’t just about having children? What if a wacky cycle is a clue something else could be wrong? This is what Lisa Hendrickson-Jack teaches in her book, The Fifth Vital Sign, and we had the opportunity to chat with her a while back about vagina stuff. This brilliant lady is a certified Fertility Awareness Educator and Holistic Reproductive Health Practitioner who teaches women to chart their menstrual cycles for natural birth control, conception, and monitoring overall health. I’m so excited to finally share this interview with you. It’s long overdue. We broke it into 3 parts for ya to digest it better, so enjoy!

 Part 1

Joelle:

What is a vital sign and why should we consider a menstrual cycle a vital sign?

Lisa Hendrickson-Jack:

I think that we're all familiar with the most common vital signs. So a vital sign is a bodily response that you can measure, and so the most common ones are our heart rate, body temperature, respiratory rate, blood pressure. And what's interesting about all of those vital signs is that we all have a sense that there's an accepted range of what is normal.

If your doctor's measuring your vitals and something's off, then it's a sign not only that something is actually wrong, but it also gives the doctor a bit of a roadmap of where to look for what's going on. So if your blood pressure is high, well, that's a problem. But it also tells the doctor, okay, these are the couple of reasons why the blood pressure might be high, so it gives them a sense of where to start looking.

What's interesting about the menstrual cycle for women of reproductive age is that it serves a very similar purpose. For women of reproductive age, we're supposed to have regular ovulatory menstrual cycles, meaning that we're supposed to ovulate. The cycle doesn't always have to be exactly 28 days, but in a healthy woman it ranges from about 24 to 35 days and we should ovulate. And then there's a lot of different features of the menstrual cycle that also have an accepted normal range.

When your menstrual cycle is regularly falling outside of those ranges, for instance, one of the clearest examples is in the case of Hypothalamic Amenorrhea, HA is when a woman stops ovulating and so she stops getting her period altogether. We commonly see something like that in athletes when they're exercising a lot, because HA is characterized by a combination of stress, over exercise and under eating.

So what's interesting is that we think, oh, well, she lost her period. But did you know that when a woman loses her period for six months or more, it increases her lifetime risk of developing osteoporosis? When we look at the menstrual cycle as a vital sign and actually look at having a normal ovulatory menstrual cycle as important for health, then we can understand that if the cycle is off it could actually mean something fairly significant about a woman's health.

It's not just about making babies, because if you don't want to make babies, you do want to have healthy bones. Your ovulation is also linked to a lower risk of certain heart conditions and also metabolic risk factors up to and including diabetes.

So again, we should be looking at a woman's menstrual cycle. Imagine if you went to your doctor and you know they check your blood pressure, they check all the regular vitals but they're also doing a bit of a more extensive check by asking questions like “are you ovulating regularly? Are your periods normal?”

I'm not sure why we're not looking at it for women of reproductive age. But particularly in adolescents, there's been a call to have the menstrual cycle looked at as a vital sign so that when doctors are seeing teenage girls, that they're actually asking these questions and looking at it because it can have significant lifetime implications. If a teenager is not ovulating regularly, given the bone loss issue we don't need to have 20 year olds at risk of osteoporosis, so we should really be looking at this as a serious thing.

Joelle:

What does a normal, healthy menstrual cycle look like?

Lisa Hendrickson-Jack:

We often think about the menstrual cycle as if you have your period and then fast forward and then you have another one, so what happens in the middle, right? When we're looking at how to determine if a cycle is healthy we also want to look at what happens throughout. So a period, for example, a healthy period lasts about three to seven days.

There's a such thing as too light. If your period's one or two days, well, I would want to know if it's really your period. So a true menstrual period happens after you've ovulated. In a healthy cycle your period would actually come about 12 to 14 days after ovulation. A lot of women don't know that so when you're on birth control that's not your period because most birth control methods prevent ovulation so you're not really having a true period. So that's the first thing, three to seven days.

A healthy period we would expect it to start off moderate to heavy and gradually taper off and then stop. So if it just goes on and on more than a week, if you're bleeding throughout your cycle, those are things that we should really be looking at. That's outside of what we would consider normal.

And although it's very common for women to experience varying degrees of pain with their periods, moderate to severe pain is (although common) a sign of a problem. I always say outside of menstruation, I can't think of any examples where moderate to severe pain are thought to be completely acceptable.

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