Code Red: What Every Woman Should Know

First of all, let me say this: I get it.

Conversations about menstruation aren’t the most fun to have, especially those conducted in all earnestness and honesty. It’s much more fun to bemoan and joke about, right? Frank period talk is a somewhat boring, gorey, discomforting topic that many of us would rather avoid.

However, knowing your body, how it works and when to advocate for it is important!

So let’s do this – I’ll make it fun! Not only will this post equip you with some essential menstrual knowledge & tips, it will enlighten you as to the huge range of appropriate (or perhaps, inappropriate?) euphemisms used around the world to refer to a woman’s menses. That’s the last time I will say “menstrual”, “menses” or “period” – pinky promise!

woman in red dress covering her ears

Jenny’s Red Dress Doesn’t Fit Me

Part of the beauty of being a woman (and a human being in general) is how vastly different we all are. Jenny Has a Red Dress and her dress is tailored to her, and doesn’t necessarily fit anyone else. Each one of us unique, and so are our Visits to the Red Planet.

For some, Arts & Crafts Week at Panty Camp is a lighthearted affair involving a couple of tampons and a few liners. These women fall just short of unicorn status and are to be envied. These lovelies have the comfort of knowing that everything is on track without seven exhausting days Riding the Crimson Wave (all the while wondering if the extreme blood loss they seem to be experiencing is “normal” or if perhaps they should go see the doctor).

The biggest key to knowing that your body is healthy and on track is knowing what is normal for you and being alert to changes – be that pregnancy, hormone imbalance or perimenopause! Jot down notes in a little journal or download an app for your phone – you’ll thank yourself later!

In addition to keeping track, I think it is also helpful to keep some basic parameters in the back of your mind and have reliable resources to refer to. I highly recommend you bookmark the Centre for Menstrual and Ovulation Research website. It is a great resource!

A Normal Ram a Tam

as defined by CeMCOR

Daily Expected Volume

2 tsp or 10 ml
(2 soaked regular sized pads/tampons)

Days of Flow

Two to Four Days

Total Length

Three to Six Days

Total Volume

20 ml (4 tsp) to 80 ml (16 tsp)

Cycle Length

24 to 38 days
(from 1st day of your Monthly Trouble to the next time it starts)


A variation of plus or minus 20 days is still considered “regular”

So…what if your Drive through the Redwood Forest falls outside those parameters?

Chat with your doctor about it, I mean it! She (or he) can rule out cause for concern and may be able to help. For example, if you tend to have very heavy flow (every time the Red Sox Have a Home Game you lose more than 80 mls) you may be at risk for iron-loss induced anemia. (Fatigue anyone?). Commonly, a very heavy flow is caused by high levels of estrogen that causes an extra thickening of the lining of the uterus. Something as simple as taking Ibuprofen can inhibit the thickening which in turn will substantially decrease your flow. Ask your doctor about it! They can test you for anemia, suggest appropriate supplements if needed and figure out the best way to proceed.

Hormones & Pressure: Pain Culprits

So what is with all the cramping and exhaustion?! For many of us, when Aunt Flo Comes to Visit, life gets a little tough. Painful cramps are a result of two things: estrogen and uterine pressure.

As we are all well aware, hormones can take us for quite a ride. From the time we are teenagers until after menopause, we feel tossed about by the whims of our hormones. We “credit” them with causing irritability, cravings and general mood swings… but pain? Yup! When we experience high levels of estrogen, our bodies produce more of those fun little pain hormones called “prostaglandins!” Of course, through life we naturally go through stages with higher levels of estrogen. But there are other things that increase estrogen levels (or lower the lovely counterbalancing hormone known as progesterone) and consequently bring increased pain when Granny is Stuck in Traffic. A few examples are: low levels of activity/exercise, weight gain, stress, illness, poor nutrition and depression. Your body’s overall well being really does impact the pain you experience when Communists Take Over Your Summerhouse (that one somehow seems especially wrong to say!).

There is another piece to the pain puzzle that I find particularly interesting: PRESSURE.

This one is intuitive in some ways. We feel it! The more pressure your uterus is under, the more it releases prostaglandins (ie you are in more pain). When you are a teenager and your uterus is growing and strengthening, that can increase the pressure you experience and make your period painful. Also, when the opening to your uterus is tight, there is greater pressure there too. Your body has to work hard to dispel the endometrial lining!

One reason I find the pressure aspect particularly interesting is because I have an unanswered question. There is plenty of subjective evidence indicating that an internal menstrual device (such as a cup or tampon) increases cramps for some women. But why? Keeping in mind how hard your uterus works to dispel the old endometrial lining and the fact that the size of the opening to your uterus makes a difference to the level of pain you experience during the Coming of the Cranberry Woman, I wonder if the reason for increased discomfort is that when an internal device is inserted it likewise increases pressure and boosts the production of prostaglandins? Interesting!


It’s interesting to note that Ibuprofen falls into the “anti-prostaglandin” category of painkiller – hence why it is effective when the English Have Arrived (with reference to the traditional red military garb, of course). The key to Ibuprofen being effective is anticipating the need. Ibuprofen prevents your body from producing those painful little prostaglandins (haha), but it doesn’t make them magically disappear once they are already wreaking havoc on your day. Good to know!

Be Kind To Yourself!

So I think this blog post can only finish off with some standard textbook recommendations. Eat well. Exercise. And… maybe reconsider your choice of feminine products! Above all – be kind to yourself! When you are experiencing cramps and tiredness, it is because your body is hard at work! You may not feel as productive, exuberant or awesome as you normally do. When Little Sister Is Here, give yourself a break.

You deserve it!

Being crazily productive can wait for another day.