You may only think about your monthly cycle during those few days when Mother Nature visits — but your period is only a small part of an intricate regulation process going on inside your body.
“The truth of the matter is, when most people learn about this stuff, they’re in seventh grade,” Dr. Lauren Streicher, an associate clinical professor of obstetrics and gynecology at Northwestern University’s Medical School and author of "Sex Rx: Hormones, Health, and Your Best Sex Ever," told TODAY. “Women who are otherwise very savvy and educated, and know a lot about their bodies, really don’t know a lot about what’s supposed to happen and what’s not supposed to happen.”
But understanding your cycle can be essential so that you not only know when you should see a doctor, but also so that you can also make peace with some of the stranger parts of your monthly hormonal roller coaster.
Here are some of the most surprising facts about your 28-day cycle that you might not know (and keep in mind, these are for women taking no oral or other contraceptives):
1. A normal cycle can vary in length.
A normal cycle can be as short as 21 days and as long as 36 days, according to Streicher. While the time from ovulation (release of the egg from the ovaries) to a woman’s period is pretty consistent — around 14 days — the time from a woman’s period to ovulation varies, Streicher explained.
2. Small clots in your period are normal.
If a woman has very heavy periods, she may have more blood clots, Streicher explained. These look like a chunky, gel-like discharge that can vary in size and color. These are nothing to be concerned about, Dr. Donnica Moore, a physician and women’s health advocate, told TODAY, noting that clotting may also have to do with how long it took for the blood to come out, and if the blood clotted internally first.
3. Taking an ibuprofen the day before your period can actually decrease flow.
If you take an ibuprofen the day before your period, you’ll actually be able to help halt the formation of prostaglandins (lipid compounds in your body), which is what causes cramps and makes bleeding heavier, Streicher explained. If you wait until later in your period, prostaglandin levels will already be high, which makes ibuprofen less effective at getting rid of these symptoms, she said.
4. Menstrual cramps are not part of premenstrual syndrome (PMS).
Cramps are actually not part of PMS, Moore said. They’re a separate part of the cycle (caused by the uterus as it sheds its lining). So you could still have PMS without cramps, or cramps without experiencing PMS, she explained. They simply aren’t part of the set of symptoms that falls under PMS.
5. Periods may contribute to anemia — but you won't become anemic after one heavy flow.
About 7-11 percent of non-pregnant women are anemic, Moore noted. However, she stressed that you won’t become anemic after one heavy period: Generally, anemia is due to a gradual depletion in iron stores over time, such as if you have heavy bleeding month after month.
You might be anemic if you are very tired all of the time or get lightheaded when you stand up quickly, Streicher explained. Another indication is, if you pull down your lower eyelid and look in the pink part, you see that it’s very pale, she said.
6. Changes in your vaginal pH levels can lead to odors.
Your vaginal pH hovers around 3.5-4.5 normally (compare that to blood, which has a pH of 7.4), Streicher said. Your period can throw off this pH, which can lead to odors or unusual discharge, though you can use over-the-counter gels like RepHresh to help restore normal pH, she explained. (However, skip the pH-balanced wipes, Streicher said — they’re like washing your face when trying to get rid of bad breath.)
7. Your cycle affects your sex drive.
Your hormone levels change throughout your cycle, including your testosterone levels. The higher the testosterone, the higher the libido, Moore said. These levels go up during your peak fertility time, Streicher explained — when you are ovulating, or 14 days before your period.
8. You can get your period without ovulating.
You could shed the lining of your uterus without ovulating, Streicher said. That occurs after a buildup in the lining of the uterus, which is part of the normal thickening during a cycle. If it gets too thick, the lining may shed, even if you have not ovulated, she explained.
9. Blood is not always a period.
Similarly, you could have spotting in between periods that has nothing to do with the shedding of your uterine wall. Any number of reasons could be to blame, from a cervical cancer, to early pregnancy and implantation bleeding, to simply breakthrough bleeding that is nothing to be concerned about (the majority of cases), Moore said. Call your doctor if it’s the first time you’ve experienced this type of bleeding, or if you’re experiencing pain along with it, she advised.
10. There’s no “safe time” when you can’t get pregnant.
“I tell people some times are safer than others, but there’s no absolutely safe time,” Streicher explained. While you’re more likely to get pregnant during certain stages of your cycle (like when you start ovulating), you still can get pregnant during other times as well, she said.
11. You don’t HAVE to have a period every month.
Some women don’t have a period every month, or have slightly longer cycles, Moore said. This isn’t necessarily a cause for concern — mention it to your doctor so you can both discuss any further evaluations you may need, she recommended.
Even if you don’t get your period every month, you still could get pregnant, Streicher noted. Though getting your period every month is a good sign of fertility, the strongest sign is still age: Women experience a gradual decline in fertility each year.
12. Some months your period is lighter than other months — and that's OK.
“It is absolutely normal for your menstrual flow to vary from month to month,” Moore said. However, if one month your flow is extremely heavy, get checked out by your doctor.