As you’ve probably known for a while now, menstruation is the monthly shedding of your uterine lining. Though it can be uncomfortable and sometimes inconvenient, your period is your body’s way of telling you that your reproductive system is working properly.
Just as every woman is unique, every woman’s period has its own personality. Some periods are short, others are long. Some are heavy, others are light.
After a few years’ worth of monthly bleeding, most women start to get a feel for their period’s frequency, duration, and flow. When something out of the ordinary happens — such as spotting between periods or an exceptionally heavy flow — it’s natural to wonder what’s going on.
Is There Such a Thing as a Normal Period?
Not really. The average woman’s menstrual cycle is 28 days long, and the average period lasts for three to five days, but there can be huge menstrual cycle variations from woman to woman.
“Three days is normal for some women, seven days is normal for others,” says Franklin Loffer, MD, executive vice president and medical director of AAGL (formerly known as the American Association of Gynecologic Laparoscopists). Similarly, the normal period flow can be heavier in some women than in others.
Rather than worrying about the length or frequency of your period, you need to consider whether anything has changed.
“A woman should really be tracking her own menstrual cycle, because it provides huge numbers of clues about whether something’s not right,” says Frances Ginsburg, MD, director of reproductive endocrinology at Stamford Hospital in Stamford, Conn., and assistant professor of clinical obstetrics/gynecology in the Columbia University College of Physicians and Surgeons.
Here are some common menstrual period changes, and what they might mean.
I. Your Period Has Slowed or Stopped
The big question if you’re not getting your period is — how old are you?
The cause of a missing menstrual period (called amenorrhea) varies by age. “To quit having periods at age 25 is a significantly different issue than quitting at age 50,” Loffer says.
For a woman in her 20s or 30s who is sexually active, pregnancy is always a possibility. “Even if a woman thinks she’s protected, that’s not an absolute guarantee,” Loffer says.
On the other hand, women in their 40s or 50s could be in perimenopause — the period surrounding menopause. As your ovaries slow their estrogen production, periods become less frequent. Periods also can get shorter or lighter during perimenopause. Once your periods stop for a full 12 months in a row, you’re in menopause. The average age for menopause is 51.
Another possible cause of missed periods is excessive exercise. Anywhere from 5% to 25% of female athletes work out so hard that they stop getting their periods. 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 such as anorexia nervosa can also stop getting their period. Severely restricting the amount of calories you eat suppresses the release of hormones your body needs for ovulation.
Other possible causes of missed periods include:
• Thyroid or pituitary gland disorders
• Disorder of the hypothalamus (brain area that assists with reproductive hormone regulation)
• Oral contraceptives (although birth control pills will usually just make the periods lighter, rather than stopping them entirely)
• Polycystic ovarian syndrome and other hormone imbalances
• Ovarian failure (the loss of normal ovarian function before age 40)
• Disease of the uterus (womb)
II. Your Period Is Heavier Than Normal
Most women only shed about 2 or 3 tablespoons of blood each month. Those with heavy periods (menorrhagia) can lose 5 or more tablespoons of blood monthly.
When you bleed excessively, you lose iron. Your body needs iron to produce hemoglobin, the molecule that helps…