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The health problems women are told are ‘normal’ – but a doctor says you don't have to put up with

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The health problems women are told are ‘normal’ – but a doctor says you don't have to put up with

Dr Dan Baumgardt

Published: October 14, 2026 at 2:13 PM

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Dr Dan Baumgardt explains the importance of seeking help when you need to

Normality is a difficult concept to define in many branches of medicine. Something as straightforward as normal blood pressure or pulse can vary considerably between individuals, with a range of values considered healthy – whether you lie smack bang in the middle, or near the limits.

When it comes to women’s health, defining normality is just as difficult. Periods, hormones and life stages can vary enormously – particularly in their severity and their impact on work, life and indeed love. Understanding the scale of cause and effect can really help you understand when a symptom or condition requires medical attention – since the answer isn’t always straightforward.

Why “normality” is a difficult concept

With symptoms varying so widely in their nature, severity and age of onset, it’s perhaps unsurprising that it can prove difficult to understand which ones merit seeking medical advice over, and when.

Doctors observe this variation in clinical practice, but patients also develop their own understanding of “normality” – in the context of what they discuss and observe through their peers, friends and family. What women learn about menstruation can be based off their individual experiences, and by what they’ve absorbed from other women in their families; their mothers, sisters, grandmothers, friends – whose own experiences can shape what their expectations should be like.

And these expectations can be leading – for example if heavy, painful periods are common among women in the same family, they may be regarded as an ordinary part of life, rather than something worth reporting or investigating.

Group of women talking with each other. They are wearing sports clothing.

Periods

Perhaps nowhere is the variation in women’s health more apparent than with menstruation. Periods can differ considerably in their duration, frequency, heaviness and other accompanying symptoms, including pain.

The average menstrual cycle lasts around 28 days, but this isn’t an exact science. Anywhere between 21 and 35 days is generally considered within normal limits – whilst bleeding can last anywhere between 2-7 days, with total blood loss anywhere between 20-90 ml over that period too.

When periods become heavy, we call it menorrhagia – which can also be defined as more than 80ml of blood loss each cycle. Unless you use a menstrual cup, this can prove difficult to determine – and even the idea of measuring it may not occur to some women. For those using towels or tampons, it’s an impractical value – but changing sanitary products more frequently than every 1-2 hours, having to use them both together, or bleeding through clothing or bedding can be a good indicator that your menstrual flow is significantly heavy.

Periods can also be painful. Dysmenorrhoea (period pain) affects more than 50% of women, and is often considered as an inevitable part of the cycle. Irregularity can also prove an issue, making it difficult to predict when bleeding will next occur.

When to seek help: It’s often better not to think of millilitres of blood, or of pain being an inevitable monthly endurance, but instead think of the impact that periods are having on the individual. If they’re affecting daily living, or generating cause for concern – that is genuinely enough to warrant speaking to a GP about them.

Young woman sitting on a sofa, holding a hot water bottle against her lower abdomen, visibly experiencing menstrual pain.

Premenstrual syndrome

Premenstrual syndrome (PMS) is another area of women’s health with incredible variation. Many women will notice changes in both their bodies and minds as they approach their period, which typically improve as menstruation starts. It was more commonly called premenstrual tension (PMT), but now PMS appears the more apt term – reflecting the much broader range of symptoms involved.

It’s a staggering statistic that nearly all women experience some degree of premenstrual symptoms, yet it’s estimated only 20% end up seeking medical advice about them. It’s also estimated that severely debilitating symptoms occur in around 2-4% of women – though this could be underreported.

The range of associated symptoms is vast – more than 100 have been described. These can be both physical and psychological – from breast tenderness, bloating and transient weight gain; to poor concentration, brain fog and depression. The underlying effect is likely to be related to hormonal changes which occur after ovulation. These appear to affect neurotransmitter activity within the brain – particularly serotonin, which has known associations with mood and stress.

There are several treatments that can be used to treat PMS – including the contraceptive pill and antidepressants. Simple lifestyle steps like regular exercise, a healthy balanced diet and good sleep can help too.

When to seek help: Speak to your GP if symptoms before your period are interfering with life, work or emotional wellbeing, especially if they’re worsening or not responding to lifestyle measures. Severe mood changes can reflect another form of PMS – premenstrual dysphoric disorder or PMDD – where symptoms are typically more severe, and which needs assessment and treatment.

Young adult woman sitting at home alone

Menopause

The name menopause refers to the transition point at which the fertile period for a woman ends, and menstruation stops. A natural decline in reproductive hormones, especially oestrogen and progesterone, is responsible for the eventual termination of periods. But this hormonal shift can also cause more wide-ranging symptoms, which can begin in years before periods completely stop – the so-called perimenopause.

These range from irregular periods, hot flushes and sweating (often at night) to sexual difficulties causes by vaginal dryness, and urinary symptoms. It can also trigger changes in concentration, memory and mood, including depression and anxiety. The effects can even impact the health of muscles, joints and bones – generating aches and stiffness, whilst accelerating loss of bone, and increasing the risk of osteoporosis.

But the experience of menopause can be even more variable than menstruation itself. Typically it begins around the age of 51, but there is again variation in the date at which it begins; under 45 is considered early, whereas before 40 is considered premature.

When to seek help: Speak to your doctor if symptoms are significant and impacting quality of life. These could include physical changes, like hot flushes or night sweats, or disturbances of mood, such as depression. Symptoms occurring before age 45 should also be assessed, in case they suggest an early menopause.

Sleepless woman sitting up in bed at night

But why seek advice from a doctor in the first place?

Some medical symptoms can occur as a result of an underlying condition, despite being easily dismissed as 'normal'. Take endometriosis – a condition where tissue deposits akin to the lining of the uterus develop in other areas outside of the womb, including within the pelvis, or on top of other internal organs. It can cause heavy, painful periods, or general pelvic pain, and deep pain felt during sex (we call this dyspareunia). Again, symptoms can vary enormously – from severe and debilitating, to little or no discomfort at all.

But in some instances, symptoms cannot be explained by any identifiable disease process. This can mean they become considered part of a spectrum of normal experience. But “normal” doesn’t necessarily mean insignificant – especially when symptoms have impact upon everyday health, relationships and wellbeing.

Speaking to a GP provides an opportunity to explore your symptoms in more detail, conduct an examination and suggest appropriate investigation and treatment. This might involve a pelvic ultrasound scan, hormonal treatments like contraceptives (including combined or mini pills, or the Mirena coil), or hormone replacement therapy (HRT). Other medications may also be used – to treat co-existing pain, depression, osteoporosis and other complications. In some instances, surgical intervention may be required for certain conditions.

Some symptoms, however, shouldn’t be explained away as normal. Some are warning signs – known as red flags – which you really should see a doctor about urgently. They include vaginal bleeding after sex, in between periods, or after the menopause. There are many explanations, some of which are harmless, but could also potentially suggest cervical or uterine cancer. That’s why it’s important to get these symptoms checked.

Doctor and patient discussing while sitting on sofa in lobby at hospital

Thinking of the wider picture

Beyond treatment for troublesome symptoms, it’s also important for women who might be questioning whether to check in with a doctor, to consider the wider impact of leaving certain gynaecological conditions undiagnosed, or untreated. Even when causing manageable or limited symptoms, some underlying conditions can potentially generate consequences that aren’t always immediately apparent.

One such consideration in younger women is fertility. Several gynaecological conditions can impact ability to conceive, endometriosis being one of them. Pelvic inflammatory disease (PID), caused by a sexually transmitted infection like chlamydia can also cause scarring and obstruction of the fallopian tubes – and prevent normal passage of an egg towards the womb after ovulation.

Such damage also raises the risk of an ectopic pregnancy – where instead of implanting in the uterine cavity, a fertilised egg rests elsewhere, usually within one of the fallopian tubes. This can become a medical emergency if it causes a ruptured tube, and potentially life-threatening internal bleeding. Prompt diagnosis and treatment are therefore essential.

The effects of gynaecological symptoms can extend far beyond the symptoms themselves. Prolonged heavy periods can cause anaemia and iron deficiency, leading to dizziness, faintness and shortness of breath. Frequent or unpredictable periods, or pain during sex can disrupt intimacy and relationships, with wider implications for mental health and emotional wellbeing.

One useful way to recognise patterns of symptoms, and establish impact is to keep a diary. Record your period length, volume and any associated symptoms – and not just pain. Jot down any other signs you notice – like problems during sex, passing urine, any changes in bowel habit, or fluctuations in mood. Sometimes it can be really difficult to recall the frequency and impact of symptoms, especially if it’s taken you a while to discuss this with a doctor.

So, perhaps we should cast aside the notion of establishing normality – and move away from the idea of what’s normal altogether in our attitudes towards these symptoms. Women’s health is characterised by enormous variation and even symptoms that are considered commonplace and within accepted limits can still merit clinical attention. Ultimately what matters here is impact – and to be able to do something about it, regardless of whether there is an underlying cause, or not.

Common, or inevitable, doesn’t always mean acceptable. And normal doesn’t mean having to endure it.

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Authors

Dr Dan Baumgardt

Dr Dan BaumgardtSenior Lecturer in Neuroscience

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