Period problems
Period problems can include dealing with painful periods, losing a lot of blood (called a heavy period) or a period that does not arrive on a regular schedule. Periods can also cause unwanted changes in your mood.
Most period problems like these do not have serious health implications. But they can be difficult to live with and get in the way of your daily life.
For most people, their periods come every 28 days or so (though this can vary from 21 to 38 days) and lasts a few days. It's the stage in the menstrual cycle when there's bleeding from the vagina.
If there are sudden changes to your usual period, it’s a good idea to contact a doctor or clinic. They can check that it’s not a sign of another condition. You should see someone if your period comes with:
sudden and severe pain in your abdomen
a large number of blood clots in your period
strongly unpleasant-smelling discharge
Painful periods
Period pain is usually felt as cramps in the lower tummy. Some people feel it in their back and thighs. The pain can come in intense spasms. At other times it’s duller but could be constant. These cramps usually start when your bleeding begins and last 2-3 days (48–72 hours).
You can help manage the pain at home with:
painkillers like ibuprofen, aspirin or paracetamol
heat - putting a hot water bottle or heat pad on the area
gentle exercise
massaging the area using light, circular movements
What causes it
When you have a period, the muscular wall of the womb tightens (contracts). These contractions can have different strengths. They can feel different from period to period, as well as from person to person.
The contractions help remove blood and tissue from the womb. But they can also compress the blood vessels that line the womb. This briefly cuts off the oxygen supply to the tissue. The lack of oxygen causes the release of chemicals that trigger pain.
Occasionally, period pain can be caused by an underlying medical condition, such as endometriosis, fibroids or pelvic inflammatory disease. If it's not caused by a condition like this, period pain often improves as you get older.
When to get help
If your period pain is severe, your GP can help you discover whether another medical condition is causing it.
Once they’ve ruled out any cause for concern, they may recommend you try a form of contraception, such as the combined pill, which can help to ease period pain.
Heavy periods
Heavy periods, also called menorrhagia, are when you need to change your pad, tampon or menstrual cup more than every 2 hours, or if you pass blood clots in your period.
On average, periods last between 2 and 7 days. It’s usual to lose around 2-3 tablespoons of blood. Some people bleed more than this, and in most cases, there’s no underlying cause to worry about.
There are some things that we know can cause heavy periods. These include:
uterine fibroids
polycystic ovary syndrome (PCOS)
anticoagulant medication
chemotherapy
You might also get heavier bleeding when your period returns after having a baby.
Heavy bleeding doesn’t mean there’s any risk to your health. You won't always need treatment. But heavy bleeding can be upsetting and hard to live with. And if you’re losing a lot of blood, it can put you at higher risk of anaemia.
Your doctor may be able to prescribe you medication that can help with your heavier bleeding. The combined pill and the hormonal coil are also both effective ways of treating heavy periods.
Irregular periods
Changes to your hormone balance can cause your menstrual cycle to become longer or shorter, and periods to become lighter or heavier.
These changes can happen when you change methods of contraception. If you’re switching from or to a hormonal method, your hormone balance will change. It can take a while to settle and your periods to become more predictable. Usually, you need to wait for 3 months for your body to adapt to the hormone changes.
Hormone levels can also change naturally and affect your period. It's fairly common to experience changes for a few years after puberty, as you get closer to menopause, or after losing lots of weight or doing regular excessive exercise.
When to get help
It can be frustrating if your period starts when you aren't expecting it. Or you may feel anxious if your period is very late, or worry about bleeding that's a lot lighter or heavier than usual.
It’s not usually a sign of anything serious. Doing a pregnancy test, and STI test and making sure your cervical screenings are up-to-date will rule out the most common causes of irregular bleeding.
Absent periods
It’s normal for your periods to stop while you're pregnant or after menopause. Some types of contraception can also cause your periods to stop for a bit – this is a normal, healthy side effect.
1 in 25 people will find their periods stop for other reasons. This is more common when you're a teenager or young adult.
It’s not always possible to find the cause of absent periods. For some people, 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 in women under 50.
If you see your doctor about absent periods they’ll usually recommend taking a pregnancy test. Pregnancy is the most common reason for periods to stop.
If you're not pregnant and your periods have stopped, after doing a pregnancy test you could be referred to see a gynaecologist (a specialist in treating conditions that affect the female reproductive system) or an endocrinologist (a specialist in treating hormonal conditions) to find out what's causing your absent periods and to find treatment.
If you haven’t yet started your period and are 16 or over, you should see your GP.
Premenstrual syndrome (PMS)
The hormone changes around your period can cause bloating and breast pain. They can affect the levels of certain chemicals in your brain, such as serotonin, which helps regulate your mood. So you can feel low, easily upset or irritable.
These changes are known as premenstrual syndrome or PMS.
You might also notice changes to your appetite, skin and hair, sleep patterns and sex drive. These symptoms usually improve when your period starts and disappear a few days afterwards.
A healthy diet, regular exercise and regular sleep can all help manage the symptoms of PMS. And any technique that helps you relax, like yoga or meditation, can also help.
Some people will experience a more severe version of PMS symptoms. This is known as premenstrual dysphoric disorder (PMDD). The symptoms of PMDD are more intense and have a greater effect on your day-to-day life.
If you're experiencing extreme symptoms and need urgent advice you can:
call 111
call a GP and ask for an emergency appointment
Getting support
You might find it helpful to talk to your family or partner about your periods. Especially if they're affecting your ability to do daily tasks, or if heavy bleeding means you don’t want to have sex or any close physical contact.
Do talk to your GP if you're worried about any problems with your periods. They’ll look at your medical history and talk with you about your symptoms. They may ask about your menstrual cycle, sexual activity and lifestyle.
Depending on what’s happening for you, they may take a blood sample or do a pelvic exam. This may feel a little uncomfortable but should not hurt.
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