Thank you all for filling out the Ask Auntie Barbie Survey! I’ve compiled the answers to your questions here for easy access. Keep in mind, I’m not a doctor. I’m a bodyworker specializing in reproductive and digestive health. My training as a Visceral Manipulation™ and Functional Methods practitioner, as well as an educator of the Arvigo Techniques of Maya Abdominal Therapy® involves years of anatomy and physiology education. I’m also a student of Dr. Aviva Romm’s Herbal Medicine for Women course which involves an in-depth look at the functioning of the reproductive system. I’ve also been monthly menstruator for the last 32 years (I’ve had about 384 periods!), so I’ve learned a thing or two along the way. Yes, I’ve bled on and off for around 2,000 days and I’m still alive and happy to have my periods! That said, this blog is for educational purposes only and shouldn’t be used as a replacement for medical treatment.

#1 Let’s start with the question, “where the heck is my uterus?” I know you may know in general where your uterus is but please don’t skip over this explanation, it’s important to know your body and how it works in order to care for it properly. Knowing where your uterus and ovaries are and what they look like deepens your connection to your body and it’s messages. Watch the video explanation of Where The Heck Is My Uterus and Ovaries <<<click and HERE for more anatomy geekiness.

#2 “How often should I bleed?” This is an excellent question! Your initial periods may be irregular with long stretches of amenorrhea (absence of menstruation) because your system is still maturing. Your cycles may vary for a while but should usually be in the every 21-45 day range in those first years after menarche (onset of menstruation). (source 1) If your cycle is way out of this range and you’re experiencing other symptoms, it’s best to talk to your parents about setting up an appointment with a Nurse Practitioner, or Gynecologist (a doctor who specializes in female reproductive health). Once your body starts to ovulate (release an egg from your ovary) regularly a typical cycle (from the first day of your period to the day before your next period starts) is usually anywhere between 21-35 days for most menstruators. If your cycles are on the shorter side (every 26 days or less), you may want to monitor your iron levels since shorter cycles mean that have more frequent periods, putting you at risk of anemia. It’s important to establish what is normal for you, so you may want to start to keep track using a period APP. I use Kindara, but you can find others. Other period tracker apps worth checking out include iPeriod and Period Tracker Deluxe. Some girls who have late onset ovulation may take 8-12 years to establish regular cycles! Your body needs time to mature, that’s why, in my opinion, taking oral contraception to control painful periods is a bad idea. The birth control pill stops your own production of hormones and replaces it with synthetic “hormones”. The hormones that your ovaries produce are not only important for reproductive health but also for brain, bone, skin, and breast health. Synthetic hormones do NOT have the same benefit as the hormones your body produces.

#3 “How long should my period last?” Typically 2-7 days.

#4 “Why do I get constipated before my period”  Progesterone is a hormone that, amongst many things, acts as a muscle relaxant (3). Progesterone is highest during the second half of your cycle, so it’s possible that progesterone may affect the motility of your colon at that time, slowing down peristalsis (wave-like movement of the colon). This doesn’t mean that progesterone is to blame for your constipation, or that you need to lower your progesterone if you get constipated. Progesterone is a good thing and has many benefits. The natural ebb and flow of progesterone alone wouldn’t be enough to cause constipation, otherwise, every menstruator would get constipated right before their period and that’s just not the case! If your diet, water intake and movement routine, etc. were rockin’, the increase in progesterone wouldn’t tip the apple cart. For constipation causes and solutions read Constipation AKA Log Jam.  Another possibility of constipation right before your period may be a retroverted uterus (tipped back). The uterus can double in size right before your period, so if it’s pressing against the rectum (the poop chute) it can narrow the poo’s pathway, causing constipation (a log jam), or thinner stools (see image below).

#5 “Why do I get diarrhea when I start my period? Not everyone gets diarrhea (A.K.A. poop smoothie) with their period. Again, it’s a sign that there’s an imbalance. Your body is trying to tell your something! Symptoms are messages from your body and the diarrhea message is NOT that you are deficient in Pepto Bismol!  Poop smoothies at the start of your period may have to do with the natural drop in the hormone progesterone. Again, the drop is natural but alone shouldn’t cause Hershey Squirts. Most likely your back door trots are related to inflammatory prostaglandins (compounds with hormone-like actions). Excess inflammatory prostaglandins can cause menstrual cramps and diarrhea. So, eliminating foods that cause inflammation is the first step.The main inflammatory culprits are dairy (especially A1 dairy), sugar, coffee, wheat, and vegetable oil. If eliminating these items is overwhelming, pick one thing at a time to eliminate. I suggest ditching the sugary coffee drinks (if that’s your thing) which usually contains three of the ingredients you want to avoid! I promise you that once you break the coffee and sugar habit you’ll have more energy and feel a ton better. If you love the coffee flavor, try to replace your usual sugary coffee beverage with half decaf then full decaf and replace the sugar and cream with grass fed butter, collagen powder and a two drops of flavored liquid stevia. I know it sounds weird, but try blending it up and let me know what you think. The second thing you can do is replace the vegetable oil with coconut oil, ghee or butter from grass-fed cows. If you think “replace” instead of “remove”, you most likely won’t miss the food that’s been replaced. Now, if replacing one or two of the inflammatory foods don’t eliminate your cramps it doesn’t mean that it’s not making a difference, it just means that it’s only part of the problem, or you haven’t given it enough time. Everything you do and don’t do now can have an effect on your next three periods!

#6 Do I even need a period? The “period” (shedding of your uterine lining) is a part of your hormonal cycle. Ovulation is also a part of the cycle that goes hand in hand with periods. If you ovulate, you need to bleed (unless you become pregnant). So, the question should be “Do we need to ovulate?”. The answer is yes. Without ovulation, you wouldn’t make estrogen or progesterone. “During bone growth estrogen is needed for proper closure of epiphyseal growth plates both in females and in males.” (2) By the way, your bone density is developing for the first 25 years of your life, so please don’t interrupt the process by taking synthetic hormones! Estrogen and Progesterone also have an effect on the brain, heart, skin and other tissues of the body. Again, that’s why I’m not of fan of “regulating your cycle” with birth control pills, especially when your body is still maturing. Regardless of what some experts may say, birth control pills don’t fix or regulate your cycles, they halt the natural process altogether! If you’re thinking about going on hormonal birth control, please first read Holly Grigg-Spall’s Book Sweetening The Pill first. The book inspired the making of a documentary Sweetening The Pill, check out the trailer below.

#7 Why does my period start and stop.My friend Nicole Jardim wrote an article on this very subject, so check it out >>> HERE

#8 What does the moon cycle have to do with my cycle? I wrote about the moon, menstrual cycles and natural light exposure in the article Moon Cycle and The Menstrual Cycle. Or, Dwight sums it up nicely here:

#9 Does uterine position matter? The short answer is, “it depends”. The uterus is supposed to move in many directions, the problem is when the uterus is stuck in any one position. The uterus must be mobile for proper function. When the uterus is fixed in one position fibrosis of the ligaments can result and impair local circulation. When circulation is impaired, the cells won’t get proper nutrients or oxygen and pain and dysfunction will follow. Some symptoms of an immobile uterus may be:

The good news is there are ways to prevent and correct a “tipped” uterus. For more information read the following articles, Uterine MobilityRetroverted Uterus, Can The Uterus Be Trained To Stay? And watch the video below for information on why your bladder doesn’t like an anteflexed uterus:

#10. Why does my back hurt during my period and what can I do about it? 

#11 Why are my periods so heavy and what can I do about it? There can be many reasons for heavy periods, so identifying the cause is the first step, talk to your ND, doctor, Nurse Practitioner, or other women’s health specialist. That said, many menstruators think they have heavy periods when they technically don’t. So, first identify if you do in fact have a heavy period. A regular tampon holds about one teaspoon of blood (5 ml), soaking 16 or more tampons during a menstrual cycle would be considered excessive bleeding. The average 30-40 ml blood loss would soak between six and eight regular tampons.  A “super” tampon can hold 10 ml of blood, therefore, eight or more soaked “super” tampons would be considered excessive. I wrote about the causes of heavy menstrual bleeding HERE. Keep in mind that because you’re a teen, many of the causes in the article may not apply, it may be that your endocrine system isn’t mature yet. I won’t go into the “what to do about it” beyond general guidelines since the treatment program would depend on the cause and the individual. If your doctor doesn’t find a cause for your heavy bleeding, here are some general guidelines that may help:

  • maintain healthy blood sugar levels
  • improve uterine tone by learning abdominal massage
  • incorporate foods high in Vitamins A, B, and C or supplement if necessary.
  • get your iron tested and supplement if needed
  • There are also wonderful herbal teas to help tone the uterus and reduce flow. I recommend working with a herbalist and asking about nettle infusion, yarrow tea, and cinnamon to slow bleeding.

OK, I’m going to stop here for now. I’ll answer the other questions in another blog post. Coming up… “What is PMS?” “Why is everyone so annoying right before my period?”

Source 1 Menstruation in young girls: A clinical perspective.

Source 2 Estrogen and Bone Metabolism 

Source 3 Effects of progesterone on motility and prostaglandin levels in the distal guinea pig colon

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