Happy, Healthy Periods & Your Fertility

By Dr. Lisa Adams, ND

We are shining a spotlight on healthy periods and women’s fertility to help you better understanding healthy periods and fertility.  Dr. Lisa Adams, ND, and seasoned expert in women’s health, addresses common questions around women’s cycles and periods like:

  • What does a ‘normal’ cycle look like?
  • Why might a period be missed or late?
  • What are normal PMS symptoms?



It’s not uncommon for women to wonder if their cycles are normal or when and if they should be worried about their cycle.  Having your period a few days late or early is a common occurrence, however it can cause a little stress when we don’t know why or what it could mean.  First it’s important to understand that it can be normal and healthy to have some variation in your cycle length. Cycle length can be defined as the number of days from the first day of your period (aka Day 1) up until the start of your next period (with proper flow, no spotting).

A healthy menstrual cycle can vary between 21 and 36 days at the very longest.  This variation will happen in the pre-ovulation phase (aka follicular phase) of your cycle. The post-ovulation phase is stable and will range from 10 to about 16 days. We often hear of the standard “28 day cycle”, which is actually only 13% of healthy women. (1) (Bull, J, Nature 2019). For our actual menses or period, we’re looking for a length of about 5 days.

If your cycles are outside this range or have changed recently, it’s time to pay attention to this vital sign. Seek assessment and guidance from an experienced health professional, such as a Naturopathic Doctor.

Learn more about the benefits and importance of charting your cycle. My tuning in and charting your own cycle and symptoms, you can start to understand your period and track fertility. Watch this video by Dr. Jessica Liu, ND to learn more.


Many lifestyle factors can affect ovulation and period timing, including stress, diet, and sleep. Medical conditions like PCOS, perimenopause, premature ovarian insufficiency, and endometriosis can also alter cycle length, period length, flow, and cause irregular bleeding. If sexually active and not using birth control, consider pregnancy as a reason for a missed or late period.

Consulting a knowledgeable healthcare practitioner is crucial. Many factors can affect period timing and regularity, so proper assessment is essential. During your visit, discuss your symptoms, cycle, health history, and consider blood work or an ultrasound.

Many women suffer unnecessarily for years due to a lack of information. Some may think irregular periods or severe cramps are ‘normal,’ often normalized by family and friends. This can prevent proper discussion and treatment with a doctor.


Many of us eCommon PMS symptomsxperience various symptoms throughout our cycle. It is especially common to have emotional and or physical symptoms in the 7-10 days before we get our period.  This is what is called the ‘luteal phase’ of our cycle (falling after ovulation). Symptoms can include menstrual cramps of varying severity, mood swings, anxiety, irritability, fatigue, breast tenderness, bloating, headaches and more.

Some of these symptoms may be generally mild and considered part of a ‘normal cyclical experience’, however, if they begin to affect your daily life and activities, you will want to discuss them with your Naturopathic Doctor who can help you better understand what a healthy periods and fertility looks like for you.

When symptoms disrupt work, family life, or enjoyment of activities, it’s time to seek help. Emotional symptoms like tearfulness, anxiety, irritability, and sleep disturbances in the premenstrual phase can significantly impact quality of life.

These symptoms may intensify in your 40’s or as you enter perimenopause, with increased breast tenderness, cramps, hot flashes, and emotional changes. Tracking your symptoms and cycle and seeking professional guidance is crucial.

By monitoring PMS, period symptoms, and fertility signs like cervical mucus and basal body temperature, you gain valuable insights into your health and hormones.  A recent study by Ponzo exemplified this(2) by analyzing data from 1867 users of the Flo app. Most of the participants reported that their premenstrual symptoms had a moderate to severe impact on their concentration (77.2%), energy (89.3%), mood (86.9%). The results at the end of the study found that most respondents (88.7%) agreed that using Flo helped them to be aware of their body signals, while 68.7% were able to improve how they managed their period symptoms.  Even more interesting is that 52.5% felt they could be more open with others about their symptoms and how they felt.

We can begin to increase our accuracy of predicting when we are fertile, when our period will come, and how our habits affect our hormones and premenstrual symptoms, and vice versa. We can give our health care providers important information to help them properly assess and diagnose important women’s health conditions. It’s a powerful tool that only we possess, because no one can understand our body and how we feel better then ourselves.

Key Takeaways:

  • A healthy menstrual cycle can vary between 21 and 36 days at the very longest, and healthy period length is about 5 days of moderate, consistent flow.
  • There are many different factors in our lifestyle, including stress, over and under-fueling (aka eating), certain health conditions, and, of course, pregnancy, that will affect the timing of our period or the experience of missing a period.
  • You should start asking questions and seeking help when your symptoms are affecting your daily enjoyment of life.
  • By tracking our PMS and other symptoms, timing and duration of our period, as well as signs of fertility or ovulation like cervical mucus and basal body temperature, we can gain many insights into our health and hormones.

Get Professional Help

For a more comprehensive assessment, and to get support to better understand healthy periods and fertility, book a complimentary call with Dr. Lisa ND.


Dr. Lisa Adams, ND

Dr. Lisa Adams, a Naturopathic Doctor, specializes in women’s health and cycle expertise. With over 15 years of experience, she has helped countless women understand their hormones. Her specialties include fertility, PCOS challenges, perinatal and children’s health, and creating hormone harmony through perimenopause.

Inspired by her own motherhood journey, Lisa is passionate about helping women, especially moms. She aims to help them manage stress, anxiety, and fatigue, so they can feel more energized and supported. Lisa believes in empowering women to confidently advocate for their health and well-being.


  1. Bull, Jonathan et al. Real-world menstrual cycle characteristics of more than 600,000 menstrual cycles. NPJ Digital Medicine. Article number 23: 2019.
  2. Ponzo, S et al. Menstrual cycle-associated symptoms and workplace productivity in US employees: A cross-sectional survey of users of the Flo mobile phone app. Digit Health. 2022.