Menstruation and periods

The menstrual period is when the female reproductive system cleans out the uterus lining and occurs every 4-6 weeks. The process involves 2-7 days of menstrual bleeding. The uterus lining is a mixture of blood, tissue and mucus. It exits the uterus through the cervix and then the vagina. Afterwards the lining in the uterus will start building up again.

Menstrual problems

While periods can be irregular at times, if you do have a change from your normal cycle that lasts for more than six months, it is a good idea to see a doctor to check that everything is OK. Common period problems include:

Painful periods

Painful periods or dysmenorrhoea is common in many women. Some women experience more severe pain that others. Period pain is usually experienced in the lower abdomen, back and tops of your legs, especially in the first few days of the period. Painkillers or anti-inflammatory painkillers such as ibuprofen, usually ease the pain if it is troublesome.

In most women the cause of period pain is not known. Sometimes it can be caused by endometriosis which is a condition of the female’s reproductive organs where the tissue that lines the uterus grows outside of it. You should see a doctor if the pain becomes gradually worse each period or begins a day or more before the onset of bleeding.

Heavy periods

It is difficult to accurately measure blood loss during a period. Generally periods are considered heavy if there is a need to use double sanitary protection, bedclothes are soaked, passing clots, or if lifestyle is restricted because of heavy bleeding. There are a number of causes of heavy periods. However, in many women, there is no abnormality of the uterus or hormones and the cause is unclear. There is treatment available to reduce heavy periods so see your doctor if your periods suddenly become heavier.

Bleeding between periods

If you have bleeding between your regular periods, you should see a doctor. This includes bleeding during or after sexual intercourse or after menopause. One common cause of bleeding between periods is breakthrough bleeding, which is lighter bleeds that occur in the first few months after starting the contraceptive pill. This usually settles over a few months.

Periods stopping

This is called amenorrhoea and pregnancy is the most common reason for periods to stop. While it is not uncommon to miss the occasional period, it is unusual to miss several periods if you are not pregnant. Other causes are stress, losing weight, exercising too much and hormonal problems. It is best to see a doctor if your periods stop for at least six months without explanation. If your periods have not started by the age of 16 it is also a good idea to see a doctor.

Irregular periods

It is quite normal to have irregular periods for a few years after puberty and before menopause. During these times the periods may be longer or shorter and also heavier or lighter. Lifestyle issues such as weight loss or gain, excessive exercise or stress can also cause irregular periods.

When to see a doctor

You should seek medical advice if you experience a change in your regular bleeding patterns. This may include:

  • heavier bleeding
  • bleeding in between the periods
  • bleeding during or after sex
  • increased abdominal pain
  • migraines

While vaginal bleeding between periods is not unusual, it should be checked by your doctor if it happens more than once or twice. Bleeding between periods can be caused by changes in hormonal levels, hormonal contraception or contraceptive devices, infection or injury.

Women may experience heavy or irregular periods around menopause (perimenopause) and it is a good idea to see your doctor to check that everything is OK and discuss possible treatment.

More information

For further information, please see: