I had the opportunity to interview Dr Alexisia Priolo, a Naturopathic Doctor about periods, fertility charting and more.  She was kind enough to submit these responses along with doing an Instagram Live (that was lost unfortunately) and I can\’t thank her enough for how helpful she\’s been!

What is a Naturopathic Doctor and what do you do with women\’s health specifically?

A Naturopathic Doctor is similar to a family doctor, with a few key differences. When someone books an appointment with a ND, an initial appointment is usually an hour long – so we can get to know you and determine what’s going on. Moreover, NDs look for and treat the root cause of disease, not only the symptoms.

Our toolbox is also quite different, generally we use nutrition and lifestyle techniques when putting together a treatment plan. But are also trained in herbal and traditional Chinese medicine like acupuncture.

What do you specialize in/prefer to treat?

I see many women with pelvic health concerns – endometriosis, urinary tract infections, IBS, etc. My main love is periods and educating women about what a healthy period looks like. We spend a large part of our lives menstruating, and I believe it’s important for all women to know what their hormones are doing, as well as common conditions that affect the menstrual cycle.

What\’s your favorite way to manage your period?  Pads? Tampons? Cups? 

I am a menstrual cup convert! I started to use one because (a) pads and tampons are expensive and (b) I wanted to see how much blood I was losing during my cycle. I’ve also started wearing period panties on the heavier overnights and they are a game changer!


Do you have a recommendation for what girls should use when they first start menstruating?

There are so many more options nowadays which is quite exciting! I think much of the decision is based on comfort and price point.

Period panties are a great option, and although they can be quite pricey they will last for a long time.

Reusable cotton pads may be more accessible than period panties and are very similar to a regular pad.

Menstrual cups are a great option if girls are comfortable inserting and removing it. It does have a steep learning curve, so that is something to be aware of.

If you choose disposable pads or tampons, I would recommend going with organic cotton alternatives. The vagina is one of the most absorbable tissues in the body and due to bleaching processes of cotton, these products may leech harmful chemicals that can be readily absorbed by the skin.

What is normal menstrual flow?  How much pain is normal for periods?

There are 4 things that I like to look for (and track!):

  1. Cycle length: Ideally a period should be between 21 and 35 days.
  2. Flow length: 2-7 days, with day 1 being significant bleeding (not spotting)
  3. Blood loss: About 20-60mL, anything above that might be cause for concern (ie. iron deficiency)
  4. Pain: Pain shouldn’t be part of your period. You may experience some slight cramping on the first heavy day, but other than that a period should come and go without much disruption.

How will a tipped uterus effect someone?

A tipped uterus may affect menstrual flow, as the endometrial lining may not be able to shed as readily or smoothly. A registered massage therapist who is experienced with Arvigo Technique may help to restore mobility of the uterus.


When does a period start to have a normal or predictable pattern?  When should I be concerned if it doesn\’t?

A period will start to have a normal pattern a few years after menstruation. However, if that doesn’t happen, and you are constantly experiencing irregular patterns then it might be beneficial to see if you are ovulating. You can do this by assessing cervical fluid, basal body temperature, or using ovulation strips.

You may also want to consider looking into PCOS as irregular periods are one of the diagnostic criteria for this condition. Other criteria include increased androgens (male hormones) found on blood work or polycystic ovaries as seen on an ultrasound.

Helpful Links

To find a Naturopathic Doctor in the US, visit: https://www.naturopathic.org/AF_MemberDirectory.asp

To learn more about me or your period, feel free to visit my website at www.alexsiapriolo.com.