A period is the part of the menstrual cycle when a woman bleeds from her vagina for a few days. In most women this happens every 28 days or so.
Why is this important
While most period problems are not serious, they can cause pain or heavy bleeding that may impact normal activities.
Sudden changes to your normal period could be a sign of a more serious condition.
Who does it affect?
The average age for girls to start their period is around 12 years old, though it can start in girls as young as 8.
90% of women experience some form of period pain or discomfort during their period. Some women also experience heavy or irregular bleeding.
1 in 25 women will stop having periods after previously having them at some point in their lives.
Absent periods are more common in teenage girls and younger women, and can be much more common in certain groups, such as professional athletes, dancers and gymnasts.
Premenstrual syndrome (PMS) or Premenstrual tension (PMT) are physical, psychological and behavioural symptoms that can happen in the two weeks before a woman's monthly period. These are thought to be a result of hormonal changes in the body. Women in their late 20s to their early 40s are most likely to experience PMS.
What is happening to my body?
Period pain occurs when the muscular wall of the womb contracts and presses against nearby blood vessels, briefly cutting off the oxygen supply to the womb and triggering pain. Occasionally, period pain can be caused by an underlying medical condition, such as endometriosis or pelvic inflammatory disease.
In most cases, no underlying cause of heavy periods is identified. However, some conditions and treatments have been linked to heavy periods including uterine fibroids, non-hormonal coil (IUD), anticoagulant medication, chemotherapy and polycystic ovary syndrome (PCOS). You might also experience heavy periods when your period returns after having a baby.
Your periods might become irregular if you change your method of contraception, as your hormone balance changes. This can cause your menstrual cycle to become longer or shorter, and periods to become lighter or heavier. It's not unusual to have a hormone imbalance for a few years after puberty and before the menopause, or after excessive weight loss or excessive exercise.
It is not always possible to identify a cause of absent periods, though in some women it can be a sign of an underlying medical condition, such as polycystic ovary syndrome (PCOS) or premature ovarian failure (where the ovaries stop working properly in women under 50).
What does this mean for me?
Any period problems can make life difficult for a few days, as you might feel irritable, or be in pain or dealing with excessive or unexpected bleeding.
These are usually felt as painful muscle cramps in the lower tummy, which can sometimes spread to the back and thighs. Sometimes the pain comes in intense spasms, while at other times the pain may be dull but more constant.
The pain usually starts when your bleeding begins, and normally lasts for 48-72 hours.
Period pain that isn't caused by an underlying condition tends to improve as you get older. Many women also notice an improvement after they have had children.
PMS or PMT
The symptoms include bloating, breast pain, mood swings, feeling irritable and loss of interest in sex. These symptoms usually improve when your period starts and disappear a few days afterwards.
These do not necessarily mean there is anything seriously wrong, but it can affect a woman physically, emotionally and socially, and can cause disruption to everyday life.
Most women have a good idea about how much bleeding is normal for them during their period and can tell when this amount increases or decreases.
These can be upsetting as your period might start unexpectedly. You may also feel anxious if your period is very late, or if your bleeding is lighter or heavier than usual. Although it is not usually a sign of something serious, you should visit a sexual health clinic or see your GP if:
- You have bleeding or spotting between periods or after sex
- Your periods last longer than 7 days
- Your periods are more frequent than once a month
- You are not pregnant and you miss two or three periods.
This means you have stopped having periods or haven’t started them by the time you are 14-16 years old. It is normal for your periods to stop at certain points. For example, your periods will stop while you are pregnant, or after the menopause. Some types of contraception can also cause you to temporarily stop having periods.
You should visit a sexual clinic or a GP if you have:
- A fever
- Sudden and severe pain in your abdomen
- A large amount of blood clots in your period
- Unpleasant-smelling vaginal discharge.
If you or your daughter hasn’t started their period by 16, you should talk to your GP.
PMS or PMT
This is thought to be linked to the changing levels of hormones in the body during a woman's menstrual cycle. These changes may affect the levels of certain chemicals in your brain, such as serotonin. Serotonin is known to help regulate your mood and make you feel happier.
Talking to your partner
You might find it helpful to talk to your partner if you are finding that your periods are very disruptive to your ability to do daily tasks, or if heavy bleeding means you don’t want to have close physical contact.
You should see your GP if you're worried about any problems with your periods.
Your GP they will look at your medical history and ask you to describe your symptoms. They may also ask about your menstrual cycle, sexual activity and lifestyle. Depending on your period problem, they may take a blood sample or conduct a pelvic exam. This should not hurt but may feel a little uncomfortable.
Try not to feel embarrassed or awkward when talking to your GP about this. They need as much information as possible to help them provide the most appropriate treatment.
Most cases of period pain can be treated at home using painkillers like paracetamol and ibuprofen. You can also try applying heat (a hot water bottle can help), gentle exercise or light massage. Stopping smoking can also help.
If your period pain is severe, visit your GP to check whether another medical condition is causing your pain. Your GP may recommend that you try a different form of contraception, such as the combined pill, which can help to ease period pain.
PMS or PMT
A healthy diet, regular exercise, regular sleep and techniques to relieve stress can reduce your symptoms and help you to relax. Some methods of contraception can help to reduce PMS or PMT.
Changing your method of contraception may be the best way of getting your cycle to settle down.
Your GP will usually recommend a pregnancy test because pregnancy is the most common cause of absent periods.
You may be referred to either a gynaecologist (a specialist in treating conditions that affect the female reproductive system) or an endocrinologist (a specialist in treating hormonal conditions) for further investigation and any necessary treatment.
Your specialist may give you a full gynaecological examination and carry out various tests, such as blood tests or scans to show the inside of your body.
You may be referred to a dietitian if you are underweight or obese.