Abnormal Periods

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 always regular Normal duration of the menstrual cycle 24-37 days Normal duration of the period 3-7 days

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.

Periods	Person characteristics	Suggested Reasons	Recommendations
Missed period and/or Late period	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 yur 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 supress 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	any woman	missed ovulation (no egg released from ovary)	Just be patient, it is often temporary
	sexually active	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

Periods	Person characteristics	Suggested Reasons	Recommendations
Heavy period and/or Long period	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 (uterin contractions) and clots in “menstual blood”	Pregnancy test and emergency visit to the doctor
	an 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	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
	an 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	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	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