First things first: there's no such thing as a 'normal' period. The average body is losing 30-90ml fluid each time, but this shedding of the womb lining can affect different women in different ways. Some experience little to no pain and have a cycle that lasts just a couple of days; for others, the gates of hell are opened, and they don't close again for seven days plus (we feel you, heavy-flow sisters).
It's common to experience a certain amount of pain, mess, and inconvenience during your period, but if some super-strength paracetemol, an evening or two tucked up in bed, and a bar of chocolate as big as your face get you through, it's still relatively manageable.
However, for some women, periods can be totally and completely debilitating—and if you think that might be you, you shouldn't have to put up with it.
Here are 6 signs your period is really severe and needs attention. It's time to stop suffering in silence.
1. You're bleeding through your protection.
Brands generally recommend changing your pad every 3-4 hours, and tampons should be switched every 4-8. If you can't even get through an hour without needing to replace your towel or tampon, need to use double protection, or have to wake up during the night to prevent leaking, your flow is extremely heavy—a symptom which can cause anemia and other health issues. Speak to your doctor, who can advise on helpful options such as a change in contraception, and always seek medical advice if you suddenly have a large amount of blood clots in your period.
2. The pain is so bad, you always have to take time off work.
It's widely acknowledged that cramps are the worst; a survey revealed that a third of women say the pain actually makes them feel depressed, and 14% of women admit to taking time off work for period pain at some point. However, if you have to stay home every time you have your period, your extreme period pain could be an indicator of endometriosis, so be sure to get checked for the condition and ask your doctor about possibilities for pain relief.
3. It makes you throw up or gives you severe headaches.
As if Shark Week wasn't enough of a bitch, period pain isn't always restricted to your tummy—you can get anything from headaches to nausea to aches in other areas like your hips, back, and thighs, and you'll probably find yourself needing the toilet a lot more than usual too. Unfortunately for menstruating women everywhere, many of these symptoms are considered 'normal', but you should consult a professional if your period makes you sick frequently, you can't keep food down, or your hormonal headaches are particularly strong, even when you've taken painkillers.
4. It lasts for weeks on end…
Particularly heavy extended periods, medically known as menorrhagia, are often a result of a hormonal imbalance, but can also be related to blood clotting disorders, pelvic inflammatory disease, fibroids, cysts, or certain birth control, so it's important to get checked out and find the underlying cause. To help your doctor diagnose you properly, keep a record of the cycle of light/heavy bleeding, along with any other symptoms like fever, nausea, or painful cramps—the more info you can provide, the quickly it's likely to be for you to get effective treatment.
5. …or you bleed between periods.
There are many different causes of bleeding between periods, and while many of them are nothing to worry about (for instance, irregularity when coming onto or off the Pill, or taking the morning after pill), they can also represent issues that need further examination, like sexually transmitted diseases, cervical or endometrial polyps, and in very rare cases, cervical cancer. Don't panic, but it's best to pay a visit to the doctor for an examination just in case. They may carry out a screening, but it's just procedure, and if it is bad news, you'll have caught it as early as possible.
6. Your PMS is out of control.
And no, we're not talking feeling kind of grumpy or being a bit snappy with your boyfriend—severe PMS could actually be a symptom of PMDD, or premenstrual dysphoric disorder, which only occurs in around 3%-8% of women. During their periods, PMDD sufferers experience extreme mood swings, persistent feelings of sadness and hopelessness, heightened irritability and anger, and very low self esteem—and it's incredibly important that they don't think they just have to shut up and deal with it, as the condition may require the help of a mental health specialist. If you recognize these emotions in yourself, visit your doctor, who can refer you to the right people. You can and you will feel better.
This article originally appeared on Cosmopolitan.co.uk. Minor edits have been made by the Cosmo.ph editors.