In general normal regular periods are signals of the normal hormonal development and normal menstrual cycles.
Many girls are curious what is normal and what should be considered as abnormality.
Normal menstrual cycle is always regular
Normal duration of the menstrual cycle is 24-37 days
Normal duration of the period is 3-7 days
Missed period – pregnancy?
During lifetime women usually face different types of disturbances of periods and the causes could be very different (simple and serious, not important and life threatening). What follows is a table indicating some of the most common reasons why women have abnormalities in their periods and some recommendations.
Missed period and/or Late period
| Person characteristics | Suggested Reasons | Recommendations |
| any woman | stress, rapid weight loss or weight gain, illness, drugs (certain strong medications including tranquilizers) | Evaluate your life style and avoid mentioned reasons |
| sexually active (unprotected sex) | pregnancy | Pregnancy test |
| using the Pill | low level of estrogen component in this brand of Birth Control Pills | Change the brand of Pills |
| former Pill user | body hasn’t yet adjusted to the “pill regime” | Be patient and wait 1-3 months. Visit your doctor if periods wouldn’t resume in 3 months |
| using Mini-Pill, Norplant, or Depo-Provera | common side effect of progestin-only contraceptive methods; drug could suppress the ovulation as well as period, effect may be prolonged; most common among new users of Norplant and long-term users of Depo-Provera | Discuss the problem with your doctor; May be you need to change the contraception method |
Light period and/or Short period
| Person characteristics |
Suggested Reasons | Recommendations |
| any woman | missed ovulation (no egg released from ovary) | Just be patient, it is often temporary |
| sexually active (unprotected sex) | early pregnancy some bleeding may occur on implantation (implantation bleeding); ectopic pregnancy especially if accompanied by sharp pain on one side | Implantation bleeding doesn’t need any special attention BUT ectopic pregnancy should be operated or treated urgently |
| using the Pill | less endometrial build up, a common Pill side-effect | Better to take a break for 1-3 months and use other kinds of contraception |
| using Mini-Pill, Norplant, or Depo-Provera | common side effect drug is probably not suppressing ovulation if periods are regular | Better to take a break for 1-3 months and use other kinds of contraception |
Heavy period and/or Long period
| Person characteristics |
Suggested Reasons | Recommendations |
| women with infections | Pelvic inflammatory diseases (PID) | Visit your doctor for treatment |
| any woman | fibroids, so called myoma (benign uterine growth); Could be genetic or hormone-depending (high level of estrogens) |
You need ultrasound testing |
| sexually active | possible miscarriage, especially if period is late and with severe cramps (uterine contractions) and clots in “menstrual blood” | Pregnancy test and emergency visit to the doctor |
| IUD user | device may have irritated the uterine wall, it is pretty common IUD side effect | Be patient, often it is just temporary |
| using Mini-Pill, Norplant, or Depo-Provera | longer periods are a common side effect; heavier periods are a less common side effect | Iron supplements or discontinuation could be necessary |
| new mother | an enlarged uterus, resulting in the accumulation of more lining; a cervix widened by childbirth releases more menstrual fluid at once with less cramping | Just be patient; it should disappear after 1-3 months |
Bleeding and/or Spotting between periods
| Person characteristics |
Suggested Reasons | Recommendations |
| any woman | stress, infections, cysts, polyps (of cervix, vagina, or uterus), fibroids | Visit your doctor for advice |
| spotting before and after period | Could be endometriosis | Visit your doctor for advice |
| a new Pill user | breakthrough bleeding, common in first few months of use, may indicate brand of Pill is not right for user | Change the brand of Pills |
| current Pill user | Missed a pill or taken one late | Read instructions what should be done if pills are missed |
| using Norplant, Mini-Pill or Depo-Provera | a common side effect, especially during the first few months of using the Mini-Pill | Be patient during first few months; it could e temporary |
| IUD user | a local infection or inflammation caused by the device | Anti-inflammation treatment; Visit your doctor |
| pregnant | normal hormone fluctuations in first trimester can cause spotting | Nothing to be worried; if continued – visit your doctor for miscarriage prevention |
Rare periods and/or Irregular periods
| Person characteristics | Suggested Reasons | Recommendations |
| teenager | During first 1-2 years periods can be irregular (development process) | Just be patient |
| after 16 | significant weight loss or weight gain; Poor nutrition and diet; smoking; Excessive intake of coffee and alcohol | Evaluate your life style |
| rare periods and excessive hair grow | Polycystic Ovary Syndrome (PCOS) | Visit your doctor for special hormonal analyses and ultrasound test |
| rare periods and lactation | Hyperprolactinemia | Visit your doctor for special hormonal analyses |
| After 40 | pre-menopause, menopause | Visit your doctor for advice |
Absence of periods (amenorrhea)
| Person characteristics | Suggested Reasons | Recommendations |
| women who never had periods | Primary amenorrhea. Reasons: mainly congenital genetic diseases |
Visit your doctor for special hormonal analyses and treatment |
| women who had periods and periods stopped | Secondary amenorrhea. Reasons: mainly hormonal disturbances | Visit your doctor for special hormonal analyses and treatment |
| food refusal | anorexia | Visit your doctor for advice |
