🎧 Episode 19: Decoding Your Menstrual Cycle: What Your Period, Cervical Mucus & Fertility Signs Reveal About Your Health | Dr. Colleen Holland
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Introduction
What does a "normal" period actually look like? And what's your menstrual cycle telling you about your overall health—beyond just whether or not you're fertile this month?
In this episode of The WOVA Circle, host Gabie Peytchev (founder of WOVA Health and fertility educator) welcomes Dr. Colleen Holland, chiropractor and fertility awareness educator specializing in reproductive health since 2001. Dr. Holland is a faculty member at Justisse College International, which trains secular fertility awareness educators worldwide.
This conversation is a deep dive into reading your body's signals—understanding period color, flow, and clots; decoding cervical mucus; navigating the fertility awareness method; coming off hormonal birth control; and preparing your body (and your partner's) for conception. Whether you're trying to conceive, coming off the pill, or simply want to understand what your cycle is telling you, this episode is packed with practical, evidence-based guidance.
In this episode, we cover:
What's normal for your period — color, texture, flow volume, clots, spotting, and how it changes across your reproductive life
Red flag symptoms — severe pain, heavy bleeding, low basal body temperature, and when to seek professional help
Cervical mucus decoded — what it is, why it matters for fertility, the difference between estrogenic and gestational mucus, and what continuous mucus means
Vaginal health basics — why you should never use scented products, why soap isn't needed, and the truth about discharge
Period products — tampons vs. cups vs. pads, why organic cotton matters, and how the vagina absorbs toxins directly into the bloodstream
The fertility awareness method — what it is, how to track your cycle in just a few minutes a day, and when to work with an instructor
Coming off birth control — the nutrient depletions, gut imbalances, light-dark cycles, and why a minimum three-month prep matters
The male factor — why sperm health is half the equation and why it's so often overlooked
Perimenopause and the menopause transition — what to expect, why ovulation matters long-term, and how your reproductive years shape your menopause experience
⏱ Listen time: 63 minutes 🎧 Format: Video & Audio 📍 Best for: Best for women trying to conceive, coming off birth control, or anyone who wants to finally understand what their menstrual cycle is telling them about their health.
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Podcast Transcript
Welcome to The WOVA Circle
Gabie Peytchev: Welcome to The WOVA Circle: Real Talk on fertility, wellness, and trying to conceive. I'm Gabie Peytchev, founder of WOVA Health and fertility educator. This podcast is your community space for navigating the path to parenthood with evidence-based insights, authentic conversations, and genuine support. I'm dedicated to being here with you through every part of your journey.
Hi, this is Gabie, founder of WOVA Health, and today I have the pleasure of talking to Dr. Colleen Holland, who is a chiropractor and fertility awareness educator specializing in reproductive health since 2001. She's currently a faculty member for Justisse College International, which trains secular fertility awareness educators around the world. And it's only natural that we start with a conversation around the menstrual cycle.
What's Normal for Your Period — Color, Flow, Clots & Spotting
Gabie: Colleen, can you give me more information about what is normal for color, texture, flow, if you have any clots or not, is that normal? Spotting? What are the different health signals for someone to truly understand their period, their menstrual cycle, and be able to say what is normal versus not?
Dr. Colleen Holland: Sure. There's a lot of information that we can gather from our menstrual flow, and I want to say that there's a lot of normal. There's a wide range of normal, and it can also change throughout your reproductive life. When you're first starting to get your periods after puberty starts, that can look a lot different than when you're in your peak reproductive years in your late 20s. And then that can look different as well as you progress toward perimenopause.
Generally, a period would start with — we often define cycle day one as a day when you need to wear some sort of protection because the flow is enough that it's beyond just a teeny little wisp of blood on the tissue paper. That might be more spotting premenstrually. But if you have a little bit of flow and you need at least a panty liner, that's going to be probably considered your day one. And within about twenty-four hours, you want to get to your moderate to heavy level of flow for you. If you're still sticking with just a few spots per day, that's probably more premenstrual spotting than the start of that next cycle.
We like to see blood anywhere from a wine red to a bright red. Sometimes when it's a very light flow, it'll even be pink. Toward the very end of the period, it can also be just a little bit brown, and that's all perfectly normal. When we get into black or thick blood, it doesn't mean there's anything wrong, but it means there's probably some old blood making its way out. Usually we see that when there's a lot of post-menstrual spotting. A lot of people who have PCOS will have extended days of bleeding and spotting when they do bleed, and that will look like dark, thick blood.
If we're seeing clots, it doesn't necessarily mean it's a bad thing. Clots are usually a representation of a heavier flow. More importantly than the clots, I want to understand the overall picture of the flow. A menstrual period — you'll lose about 30 mL up to about 80 mL of blood. That's not a lot — that's a few tablespoons. Many people bleed a lot more than that. If you bleed less than that, usually that's a sign of lower hormones. There's a wide range of normal, and there are many reasons why we would have heavier or darker blood or heavier flow.
If you're experiencing very large clots, larger than the size of a quarter, then you might be experiencing a very heavy flow — something medically termed menorrhagia, which means it's a lot to manage. If you're changing pads every hour or so for a couple of days, that's a very heavy period. You're going to be well above that 80-milliliter blood loss. That 80 mL is throughout the entire period for that cycle. So whether you have a five-day period or a six-day period, in that 30 to 80 mL range is what's considered typical. Beyond that is considered quite heavy.
Then we would start to ask questions about other aspects of the cycle — why could there be an excessive buildup of endometrial lining? Is there a lot of unopposed estrogen in the system and lower levels of progesterone? Sometimes there are normal levels of progesterone but just very high levels of estrogen that the liver cannot metabolize out properly.
There's a lot of nuance there, and there is information that can be gathered when you work with someone who really understands the questions to ask about the flow. You'd be amazed at how much detail we can get into when we just start looking at flow, cervical mucus, and any symptoms particular to that individual.
I used to do a lot of functional medicine testing around hormones — Dutch testing, saliva testing, all kinds of things. I actually found that I could find much more accurate and actionable information by simply asking the right questions and having the client pay very close attention to what they were experiencing throughout their cycle.
Red Flags — When Pain and Bleeding Aren't Normal
Gabie: Are there any specific symptoms that you would definitely say are not normal?
Dr. Holland: The very first thing that comes to mind is extraordinary pain. We're often told that it's normal to have pain with our periods. While there can be a small amount of discomfort, especially when the contractions begin at the very beginning of the period, it should never be to the point where we can't go about our lives and do what we need to. Severe pain is a red flag that needs to be investigated.
Heavy bleeding beyond what we discussed — if you have to change a pad or a tampon, or you're wearing a tampon and a pad to get through the night, or you're changing these products every hour for a good portion of the first couple of days — those are red flags. I often find women just putting up with these atypical parameters because they've been dismissed when they bring it up with their care providers, and it's still considered something we just have to deal with.
If you have a menstrual cup and you're emptying that three times a day for three days, that's a heavy period. It often requires looking at the gut and liver function and making lifestyle changes. That can be a hard road to go down, and not everybody has the bandwidth to do that.
If someone is tracking their basal body temperature with a true basal body temperature thermometer — in their mouth or intravaginally, not a wearable device — and their temperatures are consistently quite low, barely getting to 97°F after ovulation, that is a good sign that you might have some thyroid function that is less than ideal.
Also, we want to see cervical mucus mid-cycle. Cervical mucus is a reflection of the level of estrogen in the body. As estrogen rises, cervical mucus gets clearer, more slick, more slippery, and stretchier. The vaginal environment is quite acidic, and semen is much more neutral in its pH, which would kill sperm pretty quickly. But at the time of the lead-up to ovulation, we need a fluid to keep the sperm alive. Cervical mucus has a much more neutral pH, nutrients that serve as snacks for the sperm, and provides channels for them to make their way up into the uterus.
Cervical Mucus Decoded — Types, Patterns & Fertility Signals
Dr. Holland: The cervix goes from a firm plug of mucus that keeps it impenetrable during the non-fertile times of the cycle — that's a G-type mucus, G for gestational. This was identified by a researcher named Odeblad from Sweden who studied cervical mucus. As estrogen increases, the cervical cells make a higher water content cervical mucus, which becomes an E-type or estrogenic cervical mucus. That's what we're able to see and feel at the entrance of our vagina.
When we wipe and look at the tissue, if there's any sense of shininess, those are all indications that estrogen is increasing. There's a lot of normal, and I know a lot of people get very worked up over discharge. I want to stress that we always have discharge. It's a mucus membrane — there's always moisture. That's why it's important to wear cotton underwear and minimize synthetics.
We also sweat prodigiously from our vulvas. Everywhere from moisture to moisture with white dryness on underwear to something stretchy and slippery — those are all within the realm of normal. It's when they're accompanied by itching, discomfort, burning, or odor — not a normal healthy musk, but something really not right, like a fishy or foul smell — that's usually a sign of dysbiosis, where the microbiome gets out of whack.
If someone has low cervical mucus, sometimes they need to look into their thyroid health, because low thyroid function can actually dry cervical mucus. Other things can dry it too, like use of antihistamines.
Continuous Mucus — What It Means
Gabie: Do you also see people that have a lot of cervical mucus, pretty much the whole time, and is that normal?
Dr. Holland: Yes, that's very common, especially when coming off the pill or at various times when our reproductive circumstances change — postpartum or the transition of perimenopause. They can have what we call continuous mucus.
The vagina is a mucus membrane — it's moist all the time, just like your mouth. Sometimes people are observing just cell turnover. It's one of the ways our vagina stays healthy — that self-cleaning aspect where old cells are sloughed off. That will come out with the moisture, and you may see a little white pastiness on your underwear. That's perfectly normal. If you're seeing things that have more dimension, like a glop of something on your underwear, that's probably more cervical mucus than cell sloughing.
Your vaginas are not dirty. Discharge is not gross. They're not abnormal. These are all normal things we experience because we have a natural human body.
Vaginal Health — Cleaning, Products & pH
Gabie: Let's talk about cleaning the vagina. You mentioned self-cleaning. A lot of women buy different products so they can feel cleaner and smell better. What about feminine pads, tampons, cups?
Dr. Holland: Using a product to smell differently is a sure way to wind up smelling awful, and a sure way to increase irritation, pain, and discomfort in your vagina. I strongly discourage anyone from buying any product to deodorize their vulva or vagina. That's a real sure way of messing up the microbiome and creating problems.
One thing that's not obvious: whatever products you use, especially for lubrication, you want it to be acidic — pH balanced. If you're trying to conceive, then you'd use a product that is more neutral for those times close to ovulation. But outside of ovulation, your vagina should be acidic.
I don't recommend using soap to clean the vulva at all. Warm water or cool water in the shower — that's all you need. A little agitation with your hand, wipe off any sweat, and let the water run through the area. That is the best way to keep your microbiome healthy. And think about what you're using on your hair, because that runs down your body as well. You don't want a highly chemical, highly fragranced shampoo or conditioner running down onto your vulva.
Coconut Oil, Lubricants & What's Safe
Gabie: What about coconut oil? I've heard it's a good lubricant and it's natural.
Dr. Holland: Yes, it doesn't really have a pH because it's an oil. If it is helpful and you need it, it's probably a fine choice as long as it works for you. It's not safe for latex, so if someone is using condoms or a diaphragm, they don't want to use oil-based products. The safest bet is to not use anything, really. Keep things out of the vagina other than your fingers, your partner's body parts. Nothing else is needed.
Period Products — Tampons, Cups & Pads
Gabie: What about products? Do you recommend tampons, cups?
Dr. Holland: Whatever works best for a person is what is best. If you're going to choose tampons, make sure they are unscented and organic cotton. The organic cotton ones are usually not bleached, and that does matter. If you're going to put something in your vagina, you want it to be as clean as possible — by clean, I mean no toxins.
I personally prefer external products. There are a lot of great reusable pads you can wash and reuse. If you're using one-time use pads, make sure they're not scented and as minimal toxins as possible. The cups are a great option, though my only hesitation is that I work with so many people who have endometriosis and internal products can be very uncomfortable.
The vagina is such a highly vascularized tissue — you absorb whatever is in your product straight into your bloodstream. So whatever is in your product, you better be okay with it being in your bloodstream.
Toxins, Fragrance & Why They Matter
Gabie: How much does it really matter? Because I think people sometimes underestimate.
Dr. Holland: People are going to do whatever works for them until it doesn't. Maybe they have a friend who noticed that when they used a scented conventional tampon, they had cramps, and when they switched to organic cotton, the cramps went away. Those stories exist — it happens all the time.
If you have perfectly healthy cycles, healthy vaginal health, pain-free intercourse, no infections, and your product is working for you, then that's fine. But it may be a cumulative thing over time. You may be fine for years, and then at some point you may not be. It's quite easy to avoid scented products — that's one of the big ones.
Anyone who loves women knows there's nothing wrong with the natural smell of a vulva or a vagina. Our livers have to process those fragrances because they're literally a toxin. The liver is probably the hardest working organ in the body, especially in relation to fertility and menstrual cycles. Why would we want to add more burden to that liver by adding in unnecessary fragrances?
The Fertility Awareness Method Explained
Gabie: Can you talk about the fertility awareness method? What can people do at home, and at what point do they need more professional support?
Dr. Holland: Fertility awareness method is a way of understanding and reading your body signs as they relate to your menstrual cycle. You can track cervical mucus, basal body temperature, cervical position, urinary metabolites of hormones — there are many different options. The simplest version would be tracking basal body temperature and cervical mucus.
You utilize a chart, whether paper or an app, and you start logging what you observe each day. You're learning the fertility language of your body so you can determine each day whether intercourse could end up in pregnancy.
You can bleed every 28 or 30 days and not have a healthy cycle, or not even ovulate regularly. Unless you're paying attention, you wouldn't know. Throughout our cycling years, making estrogen and progesterone in the right balance actually protects us throughout our lives — bone health, brain health, heart health. All aspects of female health are dependent on balanced hormone production.
Estrogen is a very potent growth hormone, and progesterone counterbalances that. The importance of tracking is that it tells you how healthy your cycle is, and if not, helps you understand what you can do about it. It gives insight into the health of your thyroid, cervix, ovaries, brain, hypothalamus, and pituitary gland.
The beauty is we can use that information to either get pregnant or avoid pregnancy. But I focus on utilizing it for monitoring health — that's probably the most underutilized aspect. There's a treasure trove of information.
How Long Does Cycle Tracking Take?
Gabie: How much time do you have to dedicate daily to be able to track?
Dr. Holland: In the beginning, as you're learning, it takes a little bit longer, but essentially it's a few minutes a day. If you're taking basal body temperature, you do that first thing when you wake up, within a half hour on either side of your wake-up time. That takes a couple of minutes — your partner can put it in your app or chart for you.
Each time you go to the bathroom, you create a habit. Our standardized approach is a wipe before and a wipe after, because then you won't miss an observation. Pay attention to how the wiping feels — is it slippery, smooth, or dry? Then look at the toilet paper and observe anything there.
At the end of your day, you mark down the most estrogenic quality cervical mucus observations. If you've noticed none, you mark that down too. It's creating habits that give you data.
If you want to learn a specific validated method, it's best to start with an instructor. If you can't, pick up a book like Taking Charge of Your Fertility and start learning. If you're getting to a point where you can't make sense of it, that's when an instructor can cut to the chase. If you're using this to avoid pregnancy, I always recommend working with an instructor — it can be a very unforgiving method if you don't understand what you're looking at.
If you're trying to get pregnant and four cycles in you're timing intercourse during your fertile window and still not getting pregnant, work with an instructor. You can get a head start rather than waiting a full year to qualify for fertility care.
Coming Off Hormonal Birth Control
Gabie: Let's talk about coming off hormonal contraception. There are situations where young women experience painful periods, irregular periods, signs of endometriosis, and they were given the birth control pill. Now they might be ready to get pregnant and need to stop, and all the signs are coming back. Or they're in their 20s and 30s and realize they don't want to be on birth control forever.
Dr. Holland: Birth control is a great option for symptom relief — no one likes to see someone suffer. The problem is it's not addressing why the person is suffering. It's a Band-Aid approach. Women deserve care to investigate why they are suffering and address the root issue.
Birth control stops ovulation, and we want to make sure women are ovulating as much as they can during their reproductive years because that benefits them throughout their life. Use it when we need it, but let's minimize it as much as possible.
When coming off, working with a fertility awareness educator is crucial for monitoring how your body responds. The communication between the ovaries, hypothalamus, and pituitary has been suppressed, and it takes a while for that system to come back on track. All drugs deplete nutrients and can cause gut imbalances — that's true of birth control too.
I recommend a very minimum of three months of concerted effort on nourishing your body with good nutrients, good sleep hygiene, getting out in the sun, and reorienting to natural cycles. Getting outside early in the morning to receive sunlight into your eyes stimulates the start of the day with your neurotransmitters and endocrine system. These are actual anatomical physiological processes.
Sleeping in darkness is another big thing — after dark, keep lighting dim and minimize blue light. Light is information — it can be a powerful stimulus for helping get your body back on track and reconnected to natural rhythms.
The reason I say a minimum of three months is because it takes both an egg and a sperm a full three months to reach maturity. Your body's health and the health of your cycle is a direct reflection on the health of your future baby. The healthier we can get you, even if it means taking a few extra months, it will be worth it. Your risk of miscarriage goes down. Your risk of baby having allergies, asthma, eczema — all of these go down when the egg and mom are healthier. And dad too.
The Male Factor — Why Sperm Health Matters
Dr. Holland: Usually during the time where we're working on getting mom's cycles healthier, I always make sure we have a semen analysis on her partner, because they are half the equation. I want to know now, not in six months from now when we're still trying and it's not happening, and then we check dad.
Gabie: It's much easier for both of you to implement these changes together if you feel like a team.
Dr. Holland: Absolutely. It's so unfortunately common that I'll have mom doing everything within her power — seeing the acupuncturist, chiropractor, massage therapist, nutritionist, exercising, meditating — and her partner is drinking Red Bulls and smoking cannabis every day. These things have a direct relationship on sperm health.
Gabie: It also depends a lot on the culture. In some cultures, everything falls on the woman, and it's very hard to motivate the man to make changes because they don't think they're important. Sometimes people are told it doesn't matter. I had a situation where they were doing IVF, and the sperm count was way below even the current normal range, but they were told, "You're okay, because we only need one sperm." How can this person be motivated when the expert told them they don't need to take action?
Dr. Holland: That's a really tough situation.
Gabie: But I see more and more doctors who understand how much whole body health matters.
Dr. Holland: One of the hidden benefits of menstrual cycle charting is that when you get your partner involved, it becomes a shared responsibility. I've had clients where the partner puts the thermometer in her mouth when the alarm goes off and writes it down. Parenting is a partnership. Men who love their women and want to be fathers, if given the option, will help in the process. They love learning how to interpret the charts, and they start drawing conclusions. I love seeing what charting does for a couple.
Perimenopause & The Menopause Transition
Gabie: What can women expect to see change in their menstrual cycle when they enter perimenopause? Are there obvious symptoms? How do you know you've entered perimenopause, and the transition to menopause?
Dr. Holland: This can vary. If they've had really healthy cycles, it's going to look very different from someone who's had endometriosis and relied on birth control to control symptoms. Part of the issue is that we've lost sight of the importance of ovulation in a woman's life for her health.
My expectation is that the more we have healthier cycles and ovulate, and the more progesterone we're exposed to in our reproductive years, the gentler and more efficient the transition to menopause will be. I hear people talking about 10, 12 years from their late 30s on — I think that might be an artifact of a culture that doesn't prioritize the importance of ovulation.
Even if we've never used birth control, if we're not getting outside, not connecting with light-dark cycles, constantly bombarded with blue light from devices and EMF from Wi-Fi — all of these things push us off-kilter. Our circadian and infradian rhythms are highly informed by light. Food is concentrated light. These little aspects of life that we may not give a lot of thought to have an enormous impact on orienting our natural rhythms.
We run on circadian and infradian rhythms — that's what we need. That's why we have eyes that connect to our brain. Even outside the visible spectrum, there are wavelengths of light our brain picks up. All of this is important information to keep us healthy and connected to the rhythms of our lives.
Closing
Gabie: Thank you so much for your time today and for sharing your knowledge with us.
Dr. Holland: My pleasure. It's good to see you again, Gabby.
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