Menstrual Cycle Red Flags

Published by Ańna on

Signs Athletes Should Look for

The fifth vital sign for women is the menstrual cycle. As an athlete, it’s incredibly important for not only your health, but optimal performance too. Hopefully you have a healthy, consistent menstrual cycle, but sometimes things go awry. So what are some menstrual cycle red flags you should keep an eye out for?  Three big ones: heavy periods, painful periods, and no (missed periods).  If you missed our other articles on the menstrual cycle and menstrual cycle hormones, we recommend you check those out first. 

Menstrual Cycle Red Flag No. 1: Heavy periods

Menorrhagia (A.K.A. heavy period) means you lose more than 80 mL during your period.  Anyone have any idea how many mL you lose during a cycle?  Most of us don’t, but you can figure it out.  You can use a menstrual cup with measurement markings on it. Or consider how often you change your pad or tampon. If you change your tampon or pad every 1-2 hours that’s a heavy period.

Other red flags associated with heavy periods include:

  • Passing large blood clots
  • Leaking through clothes or bedding
  • Avoiding daily activities due to your flow

Menstrual Cycle Red Flag No. 2: Painful Periods

According to some studies, 16-91% of women have painful periods. Pain is subjective.  But ask yourself if the pain interferes with your usual activities.  If the answer is yes, talk to your doctor.

Some cramping is normal, but consistent pain is not. Don’t suffer through it. As the lining of the uterus sheds, it releases prostaglandins, which cause the uterus to contract, blood vessels to contract, and increases the sensitivity of nerve endings (lowering the pain threshold).  Enter painful periods.

Rest, gentle movement like walking or stretching, and heat can all help.

Menstrual Cycle Red Flag No. 3: Missing Periods

If you miss a period once in a blue moon, it’s not too concerning.  But if you haven’t had a period in 3+ months, it could be a condition called hypothalamic amenorrhea (HA). HA is just a fancy term for missing period.

Stress, excessive exercise amount or intensity, low body fat levels, weight loss, or restrictive eating can cause HA.

The good news is it’s reversible!   You can recover by increasing your calorie intake, reducing exercise amount and intensity, increasing the types of foods you eat (adios restriction!), getting 7-8 hours of sleep per night, and reducing stress.

Check out our article here on REDS, which contains great information on what it means when you miss periods and how to get them back.  Also check out Project REDS, a fantastic resource on all things periods, performance, and low energy availability (LEA)/REDS.     


A healthy period is important for athletes. If you notice heavy bleeding, painful or missing/irregular periods, talk to your doctor. Not only will you likely feel better you resolve these issues, you’ll likely perform better too.