Problem Periods? Learn What’s Normal — And What’s Not

Jennifer N. Hong, MD is board-certified in obstetrics and gynecology. She has a special interest in contraception, prenatal care, breast and cervical cancer prevention, minimally-invasive gynecologic surgery and the management of uterine fibroids and abnormal uterine bleeding.

Is this normal? Periods show up every month, so you’d think all women should be experts on the subject. Yet menstrual cycles can vary a lot. Many women have irregular cycles, heavy bleeding or other symptoms that might make them worry.

You should expect regular periods unless you’re pregnant, breastfeeding or are going through menopause. If you don’t fit into those categories but you’re experiencing irregular, painful or heavy periods, it might be a sign of a health problem.  

Here’s what you should know about what falls under the category of “normal” — and when you should talk to a doctor.

Irregular Periods: How Regular Should They Be?

 A “normal” period typically occurs every 21 to 35 days. Hormone imbalances and other problems can make periods closer together or farther apart. Some causes of irregular periods include:

• Eating disorders
• Thyroid problems
• Polycystic ovary syndrome (PCOS)
• Weight problems
• Chronic stress

If your periods are consistently closer together than average, or you regularly skip some months, see your doctor for a physical exam and blood work to check your hormone levels. 

Heavy Periods: How Much is Too Much?

An average period typically lasts 4-8 days, with the heaviest bleeding in the first 1-3 of days. Normally, a woman loses about 80 mL of blood during one cycle. But that’s obviously hard to measure. So, how much blood loss is normal? If you find yourself regularly saturating a pad or tampon more than every 4 hours, you could have heavier-than-normal bleeding.

Heavy bleeding can be caused by a number of things, including:

• Hormone changes
• Thyroid problems
• Uterine fibroids
• Uterine polyps
• Miscarriage
• Pregnancy

If your periods are consistently heavy or bothersome to you, you should talk to a doctor to rule out these problems. And if you bleed through a pad or tampon every hour for 2 or 3 hours in a row, you should head to the closest emergency room for an evaluation.  

Period Pain: Normal or Not?

Many women experience cramps and discomfort during their periods. But sometimes, pain can indicate that something isn’t quite right. Menstrual pain can be associated with problems such as:

• Endometriosis
• Uterine fibroids
• Ovarian cysts

If your pain is severe and doesn’t ease with over-the-counter medications such as ibuprofen or naproxen, talk to your doctor.

See Your OB/GYN for Help

Bottom line: Your period shouldn’t be a source of stress. It can be easy to dismiss period problems when juggling work, family, friends and other commitments. But your health matters, too. If you have any concerns about your menstrual symptoms, talk to your OB/GYN. We’re here to help.

Learn more about Inova Medical Group Obstetrics and Gynecology, which provides expert care for women of all ages and stages of life.