Worried About Your Period?

Maureen Robb's picture
By Maureen Robb on February 4, 2019

 Your period is late. Again.

 And it's even more painful than last time. Not to mention the amount of blood.

What is a normal period, anyway?

You wish you knew!

Timing of Your Periods

Unfortunately many women complain about late, painful or heavy periods. Some experience problems occasionally, while others dread their period every month.

When should you be concerned?

“The normal length of a menstrual cycle is between 24 to 38 days, with the period lasting up to eight days,” said Jaclyn Nunziato, M.D., with Carilion Clinic Obstetrics and Gynecology.

“Abnormal is any bleeding between periods, heavy bleeding greater than 80 milliliters a cycle, a menstrual cycle that lasts longer than 38 days or is shorter than 24 days OR bleeding after menopause,” she said.

(An average sanitary pad or tampon absorbs 5 milliliters, or a teaspoon, of blood.)

The timing of your period can be influenced by a great many factors. They include:

  • Stress or life-changing events
  • Uterine fibroids or polyps
  • Endocrine problems, including thyroid problems
  • Weight-related issues, including obesity, significant or rapid weight loss, eating disorders or extreme exercise
  • Birth control methods, including pills, the patch, nuva ring, depo provera, nexplanon and IUDs. (Copper IUDs can also cause bleeding problems even though they are hormone-free.)
  • Pregnancy, including ectopic pregnancy and miscarriages
  • Breastfeeding
  • Polycystic ovary syndrome
  • Medications, including antidepressants
  • Cancers
  • Perimenopause
  • Endometriosis, a condition where the tissue lining the uterus is found outside the uterus

“If you have questions about abnormal bleeding and fertility, please see your gynecologist for further evaluation,” said Dr. Nunziato.

Painful Periods

Most women will have at least minor menstrual cramps at some point in their lives. Others will have downright painful periods.

What are possible causes of the pain, and are there effective treatments?

Menstrual cramps can be caused by hormones that prompt the uterus to contract during a woman’s period.

Other causes of painful periods may include:

  • Pelvic inflammatory disease
  • Endometriosis
  • Sexually transmitted diseases
  • A uterine fibroid or polyp
  • Use of an IUD
  • Adenomyosis (when endometrial tissue gets implanted in the uterine wall)

Heavy Periods

Heavy bleeding during your periods could be a result of a change in your hormone levels, or the use of some types of birth control. It could also indicate the approach of menopause.

But heavy bleeding can also be a sign of serious problems, such as:

  • Uterine cancer
  • Infection
  • Bleeding disorders
  • Endometrial polyps
  • Uterine fibroids

So much bleeding may also make you more susceptible to anemia.  

Treatment Options

Depending on the cause, a variety of treatments are available for abnormal periods.

Over-the-counter medications like ibuprofen are often prescribed to treat mild to moderate cramps. Aspirin is to be avoided, however, since it could increase bleeding.  

Estrogen or other hormones might be prescribed to regulate a woman’s menstrual cycle. Other options, such as long-acting contraception, including the IUD, are also available to help reduce heavy bleeding.

Uterine fibroids or polyps may be treated with medications to shrink them, or with surgery to remove or minimize them.

Endometriosis may be treated medically or surgically.

What’s Normal for You?

However you characterize your period, it’s important to know your body, and what is normal for you.

Some women have ultra-light periods all their life, and others have heavy ones.

If you have any questions at all, check with your doctor to make sure you’re in the normal range, or to discuss what steps to take to get you there.

Also remember that with women’s periods, what is “normal” can cover a broad range.

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