From the Guidelines
The first day of your menstrual cycle is considered the first day of full flow bleeding, not just spotting, and you should count day one as when you need to use a pad, tampon, menstrual cup, or other menstrual product to manage the blood flow. This means that light spotting or brownish discharge that precedes your period should not be counted as day one. If bleeding begins in the evening, some healthcare providers suggest counting the following day as day one if the flow wasn't substantial 1.
Importance of Accurate Tracking
Tracking your cycle accurately is important for monitoring reproductive health, timing fertility windows, and detecting irregularities. The distinction between spotting and actual menstrual flow matters because your cycle length affects hormonal patterns and can provide insights about your overall health. Most menstrual cycles last between 21-35 days, with bleeding typically continuing for 3-7 days, though individual patterns vary considerably.
Considerations for Irregular Bleeding
If you experience irregular bleeding, such as heavy or prolonged bleeding, it's essential to consider an underlying gynecological problem, such as interactions with other medications, an STD, pregnancy, or new pathologic uterine conditions (e.g., polyps or fibroids) 1. If an underlying gynecological problem is found, treat the condition or refer for care. If an underlying gynecologic problem is not found and you want treatment, consider NSAIDs for short-term treatment (5–7 days) or hormonal treatment (if medically eligible) with low-dose COCs or estrogen for short-term treatment (10–20 days) 1.
Key Points to Remember
- The first day of your menstrual cycle is the first day of full flow bleeding.
- Light spotting or brownish discharge should not be counted as day one.
- Accurate tracking of your cycle is crucial for monitoring reproductive health and detecting irregularities.
- Consider underlying gynecological problems if you experience irregular bleeding.
From the Research
Definition of Menstrual Bleeding Severity
The severity of menstrual bleeding required to consider a day as the start of a menstrual cycle is typically defined by the amount of menstrual blood loss.
- Menorrhagia, or heavy menstrual bleeding, is usually defined as heavy but regular menstrual bleeding of over 80 ml/cycle 2, 3.
- This definition is based on the objective measurement of menstrual blood loss, which can be affected by various factors, including age and the type of menstrual products used 4.
Factors Affecting Menstrual Bleeding Severity
Several factors can influence the severity of menstrual bleeding, including:
- Age: Menstrual blood loss increases with age 2.
- Menstrual products: The type and capacity of menstrual products used can affect the measurement of menstrual blood loss 4.
- Medical conditions: Underlying medical conditions, such as anemia, can be associated with heavy menstrual bleeding 3.
Medical Management of Heavy Menstrual Bleeding
Various medical therapies are available to manage heavy menstrual bleeding, including: