Most of us spend decades living with periods. Yet many people tell us they’ve never really been taught what a healthy menstrual cycle looks like, when symptoms need investigating or how to get the most from a GP appointment.
In fact, during the discussion, Deborah Garlick reflected that people often tell Henpicked they have learned more about their body in an hour than they have in the previous 40 years.
In this Henpicked Lunch & Learn, Sally Leech, Co-Founder and Director of Henpicked, was joined by Dr Clare Spencer, NHS GP, menopause specialist and Clinical Director at My Menopause Centre.
Together they explored some of the most common questions about menstrual health, periods and talking to your GP – from understanding what is normal to knowing when to ask for help and how to make sure you feel heard.
What is normal and when should someone seek medical advice?
Sally Leech: One of the questions we hear time and time again is, “How do I know whether what I’m experiencing is normal?”
Dr Clare Spencer: That’s a really difficult question because there is a huge variation in what can be considered normal.
The average period lasts between two and seven days. Cycle length can vary between 23 and 35 days. Some people experience period pain, some don’t. Some people have always had heavy periods and found ways to manage them, while somebody else with exactly the same symptoms may find they have a huge impact on daily life.
What matters most is how symptoms affect you.
One of the most important messages from today’s discussion was that asking, “Is this normal?” is not always the most helpful question.
A better question is:
“Is this affecting my quality of life?”
If symptoms are affecting your work, your relationships, your sleep, your ability to exercise, socialise or simply get through the day, that’s the point at which you should seek support.
There are also some symptoms that should always be investigated, including:
- Bleeding between periods
- Bleeding after sex
- Significant changes to your usual pattern of bleeding
- Periods are becoming significantly heavier
- Symptoms that are becoming progressively worse
Dr Spencer also highlighted that heavy periods can lead to anaemia and low iron levels, which may leave people feeling exhausted, foggy and unable to function at their best.
Most importantly, you do not need to simply put up with symptoms because they are related to periods.
“There are so many ways we can help,” she explained.
Why do so many people wait before asking for help?
Sally Leech: We often hear people say they assumed everyone else was coping and that they just needed to get on with it.
Dr Clare Spencer: Historically, women haven’t always been listened to when it comes to menstrual health or they have felt they just need to put up with symptoms
Many people have grown up believing painful periods, heavy bleeding or severe mood changes are simply part of being a woman.
But if symptoms are affecting your life, they deserve attention.
You do not need to suffer in silence.
That message resonated strongly throughout the session, with many attendees sharing their own experiences of living with symptoms for years before seeking support.
How can you prepare for a GP appointment?
Sally Leech: Many people worry about not knowing what information to bring or forgetting important details once they’re in the appointment.
Dr Clare Spencer: One of the most useful things you can do is keep a menstrual diary.
Track:
- Your cycle length
- Bleeding patterns
- Pain
- Mood changes
- Physical symptoms
- Sleep
- Energy levels
- The impact symptoms are having on everyday life
If mood symptoms are a concern, particularly with PMS or PMDD, tracking symptoms across at least two cycles can be especially helpful.
“As a doctor, I love it when somebody can show me a chart with all of these symptoms on,” Dr Spencer explained. “You can really quickly see what’s happening and it’s a quicker route to getting where you need to be.”
Several members of the Henpicked community also shared the apps they use to track symptoms and cycles, including:
Many said that tracking had helped them better understand their own bodies, recognise patterns and feel more confident talking to healthcare professionals.
How do you talk about symptoms clearly and confidently?
One of the biggest concerns raised during the discussion was finding the right words.
Sally Leech: Sometimes people worry they don’t know enough medical terminology or aren’t explaining things properly.
Dr Clare Spencer: Honestly, just tell us exactly what’s happening.
You don’t need medical language.
You don’t need to know terms like follicular phase or luteal phase.
Tell us:
- How often you’re changing period products
- Whether you’re bleeding through them
- Whether you’re passing clots
- How severe the pain is
- Whether symptoms are waking you at night
- How symptoms are affecting your life
“Being graphic helps,” Dr Spencer explained.
The more detail you can provide, the easier it is for your GP to understand what’s happening.
She also encouraged people not to minimise their symptoms.
“Do not minimise your symptoms.”
If symptoms are stopping you working, affecting your relationships or preventing you from doing things you enjoy, say so.
That information matters.
What questions should you ask your GP?
Many people leave appointments wishing they had asked more questions.
Dr Spencer suggested thinking about this before you go.
Questions might include:
- Does this need investigating?
- What investigations might I need?
- Do I need an examination?
- What treatment options are available?
- What are the benefits and risks of those treatments?
- What happens if this treatment doesn’t work?
- Do I need to see a specialist?
- What are the next steps?
It’s also reasonable to ask:
- Have you reviewed my medical history?
- Could another health condition be affecting my symptoms?
- Is there somebody within the practice who specialises in women’s health?
The more informed you are, the more confident you can feel making decisions about your care.
What if you’re offered treatment before a diagnosis?
This is something Sally said comes up frequently in conversations with employees and individuals.
People sometimes worry they are being “fobbed off” if they are offered treatments such as the contraceptive pill before receiving a diagnosis.
Dr Clare Spencer: Not necessarily.
For conditions such as endometriosis, adenomyosis and fibroids, diagnosis can sometimes take months or even years.
While investigations and referrals are taking place, treatments such as the pill, mini-pill or Mirena coil may help manage symptoms and improve quality of life.
Treatment and diagnosis often happen alongside one another.
The important thing is understanding:
- Why a treatment is being recommended
- What it’s designed to help with
- What happens next
- Whether investigations are still continuing
Understanding the reasoning behind recommendations can help people feel more informed and reassured.
What menstrual health conditions might be investigated?
The discussion touched on a range of menstrual health conditions that can affect people differently.
These included:
Endometriosis. A condition where tissue similar to the lining of the womb grows elsewhere in the body, often causing pain and other symptoms.
Adenomyosis. A condition where tissue similar to the womb lining grows into the muscular wall of the womb.
Fibroids. Non-cancerous growths that can contribute to heavy bleeding, pressure and discomfort.
PMS and PMDD. Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) can affect mood, emotions and physical wellbeing during the second half of the menstrual cycle.
Dr Spencer explained that symptom tracking over at least two cycles is often important when assessing PMDD.
The discussion also explored how hormone changes can affect brain chemistry and why treatments such as antidepressants may sometimes play a role in managing PMDD symptoms.
Polyendocrine metabolic ovarian syndrome (PMOS, formerly known as polycystic ovary syndrome). A complex hormonal and metabolic condition that can affect periods, fertility and long-term health.
The key message was that symptoms should never be dismissed simply because they relate to periods.
What happens if you need further support?
Sally Leech: What should people expect if they need specialist support?
Dr Clare Spencer: It depends on the symptoms and what is being investigated.
Some people may be referred to a gynaecologist. Others may benefit from specialist women’s health services or women’s health hubs, which are becoming more widely available.
Dr Spencer also highlighted that not all GPs have the same areas of expertise. Many practices have clinicians with a particular interest in women’s health.
If you feel you aren’t being heard, don’t be afraid to:
- Ask for a second appointment
- Request a longer appointment
- Ask to see a GP with a special interest in women’s health
- Seek a second opinion if needed or referral
Advocating for yourself can feel difficult, especially when you’re already dealing with symptoms, but it can make a real difference.
What came through in the discussion?
The live discussion highlighted just how many people are still trying to work out what is normal and when they should seek help.
Attendees openly shared experiences of PMDD, heavy bleeding, endometriosis, PMOS and challenges accessing diagnosis and support. What stood out most was how powerful knowledge can be. As Deborah Garlick reflected:
“People often tell us they’ve learned more about their body in the last hour than they have in the last 40 years.”
That highlights why conversations like these matter. The more we understand menstrual health, the more confident we become in recognising symptoms, asking questions and seeking support.
Why this matters
Throughout the discussion, one message came through again and again.
You do not need to suffer in silence.
Understanding your menstrual cycle, tracking symptoms and feeling confident talking to your GP about menstrual health can make a huge difference.
If something doesn’t feel right, trust yourself. Ask questions. Seek support.
And remember that menstrual health matters.
