You hardly will find two women who experience the same kind of periods. Some women have heavy and short periods, some light and long, and others sometimes skip a month. Most of what we know about our menstrual cycles seems to be an average of all our unique flows.
While your period may not follow the average flow—as very few do—it should be close. If you’re noticing periods that fall to the extreme, like really heavy periods or no periods at all, you should check in with a doctor.
1. No Periods
You are nowhere close to menopause and you are not pregnant, yet you are not seeing your period, this could be a sign of poly cystic ovary syndrome, low body fat, thyroid dysfunction or stress. Missed periods could mean you have problems with your thyroid, have a hormonal imbalance that causes cysts to grow on your ovaries, or are just way too stressed. Another possible cause: your weight. Someone who is underweight for her height can have no periods because there isn’t enough fat on her body.
Consult a doctor when: You’ve been without a period for 3 to 6 months.
2. Painful Periods
Everyone knows periods are painful, but if you’ve had painful periods for 3 months and can’t get relief from over-the-counter pain relievers, this could be a sign of endometriosis, fibroid or vaginal scarring. Every month your uterine muscles contract and release to push blood out—and those contractions mean just about everyone will feel some pain. It’s only a problem when common medications like ibuprofen don’t work, or if you regularly avoid going out with friends or even miss work because of the pain.
Endometriosis, a condition that causes the tissue you shed with each period to grow outside your uterus in places like your ovaries, Fallopian tubes, and lower abdomen. Endometrial tissue that grows outside your uterus still breaks down and bleeds during each menstrual cycle, but because it has no way out of your body, the tissue builds up and can cause pelvic pain. Although there is no cure for endometriosis, surgery or pelvic floor physical therapy has helped many women manage the discomfort. Scarring from previous surgeries or structural abnormalities in your uterus—usually caused by noncancerous tumors called fibroid—can also make periods painful. In both cases, doctors recommend minimally invasive surgery to remove fibroid and scar tissue.
Consult a doctor when: You’ve had painful periods for 3 months and can’t get relief from over-the-counter pain relievers.
3. Heavy Periods
Some women experience heavy periods, but it tends to taper off toward the end of the cycle. If you have to change your pad or tampon every hour you probably have an abnormally heavy flow. If you find yourself changing your pad or tampon more than once an hour or if you have a steady flow for more than 7 days, your period crosses the line from “heavy” to “abnormally heavy.” And if you’re constantly on edge about whether you’ll bleed through your pad and end up with an embarrassing blood stain on your pants, it’s considered “extremely heavy”. This could be a sign of fibroid, hemophilia, hormone imbalance or blood thinners.
If every period causes you this stress, it could mean you have either too much or too little of one of the hormones that regulate menstruation—estrogen and progesterone—or that you have fibroid (yes, those again). Abnormally heavy periods are also sometimes a side effect of non-hormonal birth control methods like intrauterine devices (IUDs). They can also be a sign of uterine cancer, though that’s rare.
Consult a doctor when: You’re changing multiple pads or tampons every hour, regularly bleeding through your clothes, avoiding spending time with friends or going to work, or getting dizzy, weak, or short of breath.
4. Infrequent periods
A normal menstrual cycle is anywhere from 21 to 35 days from the start of your period to the start of your next period. It’s absolutely normal for women to have as few as nine periods a year. Anything fewer than that could indicate you need to see a doctor. Infrequent periods could be a sign of fibroid, hormonal imbalance or polyps. If you’ve noticed a sudden change in your menses, don’t worry too much. Even women whose periods come like clockwork will likely miss a month or two at some point, and your period changes as you age, so a “normal” period for you could be something completely different at 40 than it was at 30. Hormone imbalances and fibroid again top the list of reasons periods can be few and far between, but polyps—benign growths on the inner wall of your uterus—can also be to blame.
Consult a doctor when: You have eight or fewer periods per year, or if your cycle was always regular but you’ve had no period for 3 months.