- Hey, y'all welcome back.
I'm Mama Doctor Jones,
a board certified OB/GYN and mom to four.
And today we're going through some
of your myth vs fact questions
from the community tab about periods.
There are tons of questions on that post.
I could probably make a video every day for a year
and not answer all of them.
We're going to do our best to get some
of the most common questions answered today.
If you're new here and you'd like to stick around,
please hit that subscribe button.
But if you don't like learning about periods,
pregnancy, gynecology, et cetera,
then definitely don't subscribe
because I promise we'll leave here
with interesting things to tell your friends.
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YellowBrickExpat says "are period cravings real
or imaginary?
Is there a real reason why I want the world's supply
of queso that week, or am I just satisfying it
in my imagination?"
And then Alison says "is the increased appetite
that you have on your period all in your head,
or do you actually need extra calories?"
You don't actually need extra calories,
at least not any significantly important amount
during your cycle.
However, that doesn't mean that cravings aren't real
or are all in your head.
I guess all thoughts are in your head.
So wanting something is kind of in your head,
but there's probably a physiologic reason why it happens.
There have been tons of studies
which validate this experience in people who have periods.
It's a very common premenstrual symptom, in fact.
Most people have experienced this at some point.
There is a physiologic reason,
or at least a physiologic association with your period.
It's probably a hormonal change that leads
to these cravings.
There's also some theories about the most common craving,
which tends to be carbohydrates
and why that is the most common craving.
And some people think that it's
because carbs increase serotonin levels
in your brain a little bit.
And that maybe your body is kind of trying to self-medicate.
If you're feeling a little down or fatigued
or having a little bit of pain,
maybe your body tells you to eat carbs
to increase your serotonin a little bit.
And that's kind of a self-medication thing
that your body does.
It does happen.
It is real. You do feel that way.
But you don't need the extra calories.
That's not the reason why.
"I'm also on the pill
and therefore I don't have real periods.
So are the cravings especially imaginary?"
Oral contraceptive pills are typically a medication
which reduces symptoms that people have
before their periods.
But that doesn't mean it universally eliminates them.
At the end of the day if you're feeling a symptom,
then it's real.
Even if it's not something
that everybody experiences when they are about
to start their period
or that most people experience when they're on pills,
you still can have some premenstrual symptoms when you're
on oral contraceptive pills.
Is it less common?
Absolutely.
Is it impossible?
Definitely not.
Hugs2003 says "periods should be five to seven days,
and anything shorter or longer is abnormal and unhealthy."
The average length of mensies is about five to seven days.
However, that doesn't mean
that less than five days is inherently abnormal.
Some people have cycles that are as little
as two to three days.
If you're regularly bleeding
for over seven days every time you have a period
that is probably not normal.
It doesn't mean anything disastrous is going on.
If you always have eight days of bleeding
and it's not bothering you, it's probably fine.
But if you're regularly having periods
that are longer than seven days,
that would be something to bring up with your doctor
and at least let us look into it
and make sure we don't see anything specifically going on
like a bleeding abnormality or something like that.
Jessica says "the normal length of cycles
and when to be concerned about irregular periods,
my period has always been anywhere from 30 to 40 days.
Sometimes I skip a month.
I get crazy looks when I go to the clinic
and they ask the first day of my last period."
On average, people will have 25 to 35 days
between cycles.
And that's from cycle day one,
which is the first day of bleeding,
to the last day right before you have bleeding again.
If you're having cycles that are 40 days apart sometimes,
three months apart sometimes,
21 days apart sometimes,
these are irregular
and you definitely should let your doctor
or advanced practice provider know.
But if your periods have always been 35 days
or 38 days apart since you started having periods,
and it's always within a couple days of that,
it may just be your normal.
I would always talk to your doctor if it's over 35 days
or under 25 days,
but there's still a chance that falls
within the realm of normal.
Especially if they are regular and not overly heavy
or overly painful or anything like that.
Now skipping periods for months at a time is not normal
and is always something that you should talk to your doctor
or advanced practice provider about
because you shouldn't be going months and months
without periods.
Unless you're on continuous birth control.
And then it's safe to skip your period
because of your birth control pills.
We'll get into that in a minute.
So Jenn C says "I heard don't swim in lakes, rivers,
or seas on your period
because blood can attract animals like sharks
if they can smell you."
And then Colleen says,
"don't go near a stallion while having your period
because they can smell it and they'll try to mount you."
These are the things I hear repeated really often,
especially the shark one,
but there's never been any evidence
that someone who is menstruating is more likely
to be the victim of a shark attack.
In general, shark attacks are incredibly rare.
I've been studying up on this while we've been living
in Hawaii for the summer.
For me to work at a clinic here,
I didn't just move to Hawaii.
Aside from the fact that shark attacks are incredibly rare,
there's also no reason to think that the small amounts
of blood that might be near you would actually
attract a shark.
In fact, if you're using a menstrual cup or a tampon,
you're likely losing less blood into the ocean
than someone who just has like a little cut on their leg
from a coral reef.
So I wouldn't worry about this.
I don't think it's a big deal.
I probably wouldn't jump
in the ocean myself if I was free bleeding.
That would freak me out.
But if you're using a menstrual cup or a tampon,
there's no reason to think that you are more likely
to be the victim of a shark attack.
The stallion one is new to me.
I've never heard this,
but I did research it for y'all
and it seems like this is something
people are commonly told.
There's actually a website, which I will link below,
if you want to go read it,
that goes through all of the reasons why this is not true
and kind of comes to the conclusion
that it doesn't make any sense.
It was a whole thing.
They discussed like the menstrual cycle
of a mare compared to the menstrual cycle of a human.
They went into great detail,
but their conclusion of people who know way more
about stallions than I do was this isn't true.
There you go.
Not true either.
Knittyspinny says "can you talk about how the lining
of the uterus works when your periods are stopped
if you're taking birth control?
Too many other women have told me
that the lining continues to grow
if you don't have a period,
and that is not the case."
So you're correct.
That is not the case,
unless you're not on hormonal contraceptives
or don't have another reason that you're not having periods.
So in people who are breastfeeding, pregnant,
on combined hormonal contraceptives,
skipping their period by skipping the placebo pills
and going straight into another pack, you're right.
The lining doesn't continue to grow.
If you're not cycling,
and you're just going months and months between periods,
but you're not on hormonal birth control,
the lining can continue to grow.
And that can be problematic.
That's why I always say here,
if you're going months and months between periods,
then you need to talk to your doctor
or advanced practice provider about that
because it can be dangerous.
That being said on birth control pills, this doesn't happen.
Why? Birth control pills have estrogen
and progesterone in them.
That means it mimics the second half of the cycle
after ovulation.
You don't ovulate on a birth control pill,
but you have hormone levels that are similar
to what we call the secretory phase
or the second half of the menstrual cycle,
which would be after ovulation.
In that phase of the menstrual cycle,
the secretory phase of the endometrium,
the endometrium is at a steady state, it's not growing,
it's being stable.
And that would be the time, you know, if you had ovulated
and got pregnant where the embryo was implanting.
So stability is super important.
When you stop your pills,
the progesterone drops drastically.
You have a cycle.
Now there is a little bit of growth
because you do still have estrogen.
And that's what prompts the lining of the uterus to grow,
which is why if you're on combined hormonal contraceptives
and you're skipping the placebo pills
and going straight into a new pack,
eventually at some point
you will start having weird bleeding
and you will need to stop for a few days
and have a period.
But in general, you're not going to see someone
who gets the lining of the uterus growing and growing
and growing and gets overgrown
and causes a problem
because the progesterone combats the estrogen
from being able to cause that to happen.
Hope that makes sense.
Leah says "why are periods blood?
Like why is that how the lining of the uterus is discharged?
Is the lining just very vascular?"
So the lining of the uterus or the endometrium,
which is what we call it, is very vascular.
That's where an embryo implants.
And so there has to be lots of blood supply there
for an embryo to implant and start growing.
Cause it needs that blood flow around it to help it grow
and a place for the placenta to start to form.
So yes, it is highly vascular.
When you have a menstrual cycle,
you do have blood that comes out,
but you also have the lining of the uterus,
which is called endometrial tissue.
When that comes out those vessels where it was attached,
they have to clot off.
And that takes a little bit of time
and you have some bleeding from that as well.
So it's just a mixture of the physiology
of how the uterine lining grows and sheds
and the fact that as you said,
it is highly vascular for an important reason.
Melissa says "tampons might make cramps worse
and your period stops when you're in the water."
Let's take the tampon one first.
I think this is a very individual thing.
There's no scientific data
that says tampons make cramps better or worse.
And anecdotally my patients have told me both.
Some people feel like their cramps are worse
when using tampons
and got better when they switched to a menstrual cup
or went back to using pads.
Some people felt like their cramps are better
when they're using a tampon
as opposed to pads or a menstrual cup.
At the end of the day,
this is very individual
and whatever makes you feel better is what you should do.
I don't think there's a universal answer to that question.
Maybe someday we'll have science that proves me wrong.
And then Melissa also says,
"your period kinda stops when you're in the water."
So the pressure of being submerged
in the water does somewhat prevent period blood
from exiting the vagina to the outside world.
However, it doesn't slow your period down
or make your period stop.
You still will have bleeding from the uterus
through the cervix into the vagina.
And eventually if you're in the water long enough,
that will build up enough pressure to combat the pressure
of the water and you'll have bleeding.
So it's not that it changes your period
or what's going on with your period.
It just makes the period blood kind of gather
in the vaginal vault or vaginal canal
instead of just immediately coming out
and then eventually it will come out.
Carli says "is it true that cramping is the uterus's way
of squeezing out blood?"
Kind of.
Cramps are mediated by hormones,
but they aren't required to get the blood out.
Some people don't have cramps at all
and they still have periods just fine.
And some people have cramps with their periods.
It is true that a cramp is like a mini uterine contraction
and that does help dispel the blood
and also helps close off those vessels
we were talking about earlier so they can stop bleeding.
However, they're not integral to having periods.
You can have periods without pain, without cramping,
or you can have some mild cramping
and that can still be normal.
You can also get pain or cramping
from blood or blood clots moving through the cervix
and into the vagina.
I have another video because I know
after that comment people are going to ask
about blood clots.
So if you want to go watch my
top five period questions video
that I filmed a very long time ago,
I will link that in the description box below.
I do talk about period poops, and clots,
and all kinds of things in that video as well.
Mary says "I've heard people say
that taking birth control is quote unquote,
saving your eggs.
I don't think that's true.
Are there cases where birth control
can help preserve fertility?"
Unfortunately, this isn't true.
We wanted it to be true and it seems like it should be true,
but we've studied this a lot.
And people who are on birth control lose eggs in the ovary,
even though they're not ovulating them
at the same rate as people who are not
on oral contraceptive pills.
This is through a process called apoptosis
where the eggs age and go away regardless
of if you're having an ovulation each month.
It would be great if that worked like that.
But unfortunately it doesn't.
And Chaunda says "the cycles of women
in the same household will eventually synchronize."
I talked about this in the myths video,
and unfortunately the answer might break some hearts.
I know it made me sad. I'm still recovering from it.
If you want to go watch that video,
I will link it in the I or in the description box below.
You can go watch that now.
I hope you learned something today.
If you did leave a like on this video,
that helps it get out to more people.
And as I said in the last video, I am biased,
but I think it is good information.
If you're new here and you'd like to subscribe,
we'd love to have you.
I will see you next Monday.
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