Did you know that the average woman menstruates about 450 times in her life? Like it or not, your period is a fact of life. By this point, you probably know what’s normal and what isn’t when it comes to your own flow and cycle—and that can be helpful, says Taraneh Shirazian, MD, assistant professor of obstetrics and gynecology at NYU Langone Medical Center: “Changes in your period can provide clues to your overall health.” We asked Dr. Shirazian and other experts to decode period symptoms (like pain and lighter-than-usual bleeding) as well as surprising side effects (including gingivitis and yeast infections). We also found natural PMS remedies that really do help, plus a piece of welcome news: You don’t have to have a period every month. Read on for everything you need to know now.

It’s OK to skip your period—really

If you occasionally hack your birth control to avoid your menses (say, during a vacation), you are not alone. About 17 percent of college students report doing it. And fortunately, it’s safe. “The idea of having a menstrual period every month is an outdated mind-set,” says Adam R. Jacobs, MD, medical director of the division of family planning at the Mount Sinai Health System in New York City. When you use hormonal contraception continuously, “the endometrial lining is thinned, which means you don’t need a period to get rid of it,” explains Dr. Jacobs. If you’re on the pill, talk to your MD about skipping the placebo pills and immediately starting a new pack. On the ring or the patch? Ask about replacing it with a new one right away instead of waiting a week. You may also want to discuss types of birth control that are designed to reduce the frequency of your period.

The pill isn’t the only option for heavy periods

We may not talk about it, but the struggle is real: Anywhere from 10 to 30 percent of women suffer through heavy menstrual bleeding, a.k.a. menorrhagia—a condition that’s often accompanied by painful cramps and, if left untreated, can lead to anemia. While many women turn to birth control pills for relief, there may be a better option out there: the Mirena IUD. A 2013 U.K. study published in The New England Journal of Medicine found that it was more effective at relieving menorrhagia than oral contraceptives and nonhormonal antibleeding drugs. The Mirena IUD releases a small amount of progestin, which thickens the cervical mucus, making it harder for sperm to reach an egg. It also makes the uterine lining much thinner, decreasing bleeding. Another hormonal IUD on the market, called Skyla, has similar effects.

You (probably) don’t need organic tampons

If you’re prone to irritation down there, organic tampons might be a better choice, says Dr. Svets, because they’re free of fragrances and dyes. But otherwise, you don’t need to splurge on the organic kind. According to the FDA, tampons have been tested and found to contain only trace amounts of chemicals (if any), and the risk of adverse health effects from such tiny amounts is negligible.

What to know about menstrual cups

Here’s a staggering number: The average American woman goes through more than 10,000 pads or tampons during her lifetime. A greener option: a menstrual cup. Usually made of silicone or rubber, menstrual cups may be bell-shaped and sit in the vaginal canal, or they may fit closer to the cervix. Instead of absorbing blood, they collect it, so you can empty and use them again and again. The cons: Some users say the cups can be tricky to insert and downright messy to remove. “It’s a matter of what you’re comfortable with,” says Dr. Svets. “But menstrual cups should be safe as long as they’re removed in a timely fashion and cleaned appropriately.” If you do use a cup, remove it at least every eight hours, and wash it thoroughly with warm water and an oil-free soap. At the end of your period, boil for 10 minutes before storing.

Your periods may get worse during perimenopause

Before they stop altogether, your periods will likely get longer and heavier (oh, joy), suggests a 2014 University of Michigan study. When researchers tracked more than 1,300 women between the ages of 42 and 52, they found that 91 percent reported that their period occasionally lasted at least 10 days, 88 percent reported frequent spotting, and nearly 78 percent recorded at least three days of heavy flow. “It’s really disconcerting for women who found their periods regular and predictable in their 30s to find them suddenly going haywire in their 40s,” says Dr. Jacobs. The good news: If you’re suffering from bad cramping or anemia, or you just want consistent menses, taking oral contraceptives should help.

Natural PMS remedies may help

Sick of popping pain relievers? Here, three research-backed, non-drug treatments to try.

Acupuncture: This ancient practice appears to reduce physical symptoms (including headaches, cramps, backaches, breast pain, and bloating) by as much as 50 percent, according to a 2014 study review. Doctors aren’t sure exactly how it works, but one theory is that it releases endorphins, feel-good chemicals that help dull pain, says Dr. Shirazian.

Chaste tree: The same 2014 review found that taking chaste tree extract (between 20 and 40 milligrams a day) improved both physical and psychological PMS symptoms by more than 50 percent. In another study, it was about as effective as the antidepressant fluoxetine (marketed under the brand name Prozac or Sarafem).

Yoga: In a Taiwanese study published last July, researchers found that women who did yoga twice a week at work for 50 minutes reported improvements in symptoms such as bloating, sore breasts, cramps, and cold sweats. Yoga may help by releasing endorphins or by relieving stress, says Dr. Shirazian.

This article originally appeared in Health.