As you probably learned in high school, menstruation It is the monthly shedding of the lining of the uterus. Although it can be uncomfortable and sometimes inconvenient, your period is your body’s way of telling you that your reproductive system is functioning properly.

Just as every woman is unique, every woman’s period has its own personality. Some periods are short, others long. Some are heavy, others are light.

After a few years of monthly bleeding, most women begin to get an idea of ​​the frequency, duration, and flow of their period. When something out of the ordinary happens, such as plucking between periods or an exceptionally heavy flow, it’s natural to wonder what’s going on.

Not precisely. The average woman’s menstrual cycle lasts 28 days and the average period lasts three to five days, but there can be large variations in the menstrual cycle from woman to woman.

“Three days is normal for some women, seven days is normal for others,” says Dr. Franklin Loffer, executive vice president and medical director of AAGL (formerly known as the American Association of Gynecologic Laparoscopists). Similarly, normal menstrual flow may be heavier in some women than others.

Instead of worrying About the length or frequency of your period, you should consider whether anything has changed.

“A woman should really track her own menstrual cycle, because it provides a lot of clues about whether something is not right,” says Frances Ginsburg, MD, director of reproductive endocrinology at Stamford Hospital in Stamford, Connecticut, and assistant professor. of clinical sciences. obstetrics/gynecology at Columbia University College of Physicians and Surgeons.

Here are some common menstrual period changes and what they might mean.

The big question if you don’t get your period is: how old are you?

The cause of missed menstrual periods (called amenorrhea) varies depending on age. “Stopping periods at age 25 is a significantly different issue than stopping periods at age 50,” Loffer says.

For a woman in her 20s and 30s who is sexually active, pregnancy is always a possibility. “Even if a woman thinks she’s protected, that’s not an absolute guarantee,” says Loffer.

On the other hand, women between 40 and 50 years old could be in perimenopause — the period surrounding menopause. As your ovaries decrease their estrogen production, periods become less frequent. Periods may also become shorter or lighter during perimenopause. Once your periods stop for 12 months in a row, you are in menopause. The average age of menopause is 51 years.

Another possible cause of missed periods is excessive exercise. Between 5% and 25% of female athletes train so hard that they stop getting their period. Called exercise-Induced amenorrhea, this phenomenon is particularly common among ballet dancers and runners. Intense exercise affects the production and regulation of reproductive hormones involved in the menstrual cycle.

For similar reasons, women who have eating disorders like anorexia nervosa, they can also stop having their period. Severely restricting the number of calories you consume suppresses the release of hormones your body needs to ovulation.

Other possible causes of missed periods include:

• Thyroid or pituitary gland disorders
• Hypothalamus disorder (brain area that helps with the regulation of reproductive hormones)
• Breast-feeding
• Obesity
• Oral contraceptives (although birth control pills It will usually just make your periods lighter, rather than stopping them completely)
• Stress
• Polycystic ovary syndrome and other hormonal imbalances
• Ovarian failure (the loss of normal ovarian function before age 40)
• Disease of the uterus (womb)

Most women only remove about 2 or 3 tablespoons of blood each month. Those with heavy periods (menorrhagia) may lose 5 or more tablespoons of blood monthly.

When you bleed excessively, you lose iron. Your body needs iron to produce hemoglobinthe molecule that helps your red blood cells transport oxygen throughout the body. Without enough iron, your red blood cell count will decrease, causing anemia. signs of anemia include difficulty breathing, unusually pale furand fatigue.

If you have a heavy, persistent flow, see your doctor for a blood count to make sure you’re not iron deficient, advises Ginsburg. If so, you may need to take a supplement.

Several conditions can increase the flow of your period, including:

You can measure the intensity of your period by the number of tampons or pads you are using. Soaking one or more pads or tampons every hour for a few hours at a time is a sign that you are bleeding abnormally and heavily.

taking oral contraceptives It can help regulate your menstrual cycle and reduce bleeding. If you use an IUD for contraceptionYour doctor may choose to insert a specific type of hormone-releasing IUD called mirena to help reduce bleeding. Another option is a medication called Lysteda, a pill that helps stop bleeding by increasing blood clotting.

If bleeding continues, your OB/GYN may recommend that you have a ultrasound or other test to identify the source of the problem.

This is a period problem that you should not ignore. “If you’re bleeding between periods, it should be investigated,” says Loffer.

The causes can range from something benign (such as having an irritated sore in the vaginal area or forgetting to take the birth control pill) to something as serious as an ectopic pregnancy or cancer. Visit your doctor for an exam.

Your period is usually not the most comfortable time of the month. Most women have electric shock as the uterus contracts to shed its lining. The discomfort is usually mild and disappears within a day or two.

But for some women, the pain is so bad that they can’t get out of bed.

Painful periods are called dysmenorrhea. They may be accompanied by other symptoms, including diarrhea, nausea, vomitingheadache or discomfort in the lower back.

Sometimes the pain is due to the period itself, but it can also be caused by conditions such as endometriosis and fibroids. To find the source of the problem, your doctor may perform a pelvic exam and vaginal cytologyas well as other diagnostic tests such as an ultrasound or laparoscopy.

Non-steroidal anti-inflammatory drugs (NSAIDs) can help because they not only relieve pain, but also prevent the body from producing prostaglandins, the chemicals that stimulate the uterus to contract during your period. Your doctor may recommend that you take the pill or get an IUD, which can also reduce period pain. fibroids and endometriosis Sometimes they are treated with surgery.

Any menstrual problem that is out of the ordinary for you warrants a call to your doctor, especially if it makes you uncomfortable or prevents you from doing your normal activities. “If a woman feels that this is interfering with her lifestyle, then she needs to address it,” says Loffer.

Definitely call your doctor if:

• Your periods used to be regular, but have become irregular.
• Your period comes more often than every 21 days, or less often than every 35 days, over several cycles.
• You bleed for more than seven days in a row.
• She stopped bleeding for 12 months straight (menopause) and now she’s bleeding again.
• You are soaking one or more pads or tampons every hour for several hours at a time.
• You have bleeding between periods.
• Your periods are very painful.