Menstrual Period Disorders
Menstrual cycles or “periods” can be irregular (the length of your menstrual cycle keeps changing) or heavy (you bleed for more than 7 days or bleed more than usual).
What Are Menstrual Period Disorders?
A lot of people do not have normal menstrual periods. Knowing what to expect from a normal period will help you know if yours are not normal (abnormal). Normal periods:
- Start 2 to 3 years after breasts start developing. This is usually between the ages of 9 and 15. Most commonly periods start at age 12 years.
- Last up to 7 days. You’ll likely need about 6 pads on your heaviest flow days.
- Have a cycle length of 21 to 45 days. You count your cycle length from the first day of your period, to the first day of your next period. Your cycle length should be similar after having your period for 2 years.
- May cause some cramping pain or headaches that over-the-counter (OTC) medicine can help.
What teens and caregivers should know about periods:
- There are a lot of products you can use for your period. It may take a few periods to figure out what you like best and what works with your flow. Accidents during this time are normal. There are:
- Pads
- Tampons – these are safe for all ages.
- Menstrual cups/discs
- Period underwear
- Ibuprofen (Motrin® or Advil®) or naproxen (Aleve®) are the best OTC medicines for cramps. Do not use these if you have a health problem where medicines like these are not safe.
- You can track your cycles by writing them on a calendar or using an app on your phone. Tracking your cycle can help record any problems you have so you can contact your doctor or health care provider.
While on your period, track:
- How old you were when periods first started
- The first day of each period
- How many days your period lasts
- How heavy the flow is or how often you change pads and/or tampons
- If you have any pain with periods
- Any other period concerns like mood changes, nausea, throwing up (vomiting) or headaches
It may take a while for your periods to be regular. This means your period is around the same cycle length each time. Most teens will have irregular periods or soiling accidents when they first start. If your period stays irregular for a while, this could be a sign of a more serious condition. This is why tracking your period is important.
What Are the Signs and Symptoms of Menstrual Period Disorders?
Contact a doctor or health care provider if your periods:
- Start younger than 8 years of age.
- Have not started by 3 years after breasts developed.
- Have not started by 14 years of age with:
- Signs of a lot of hair growth (hirsutism)
- Signs of disordered eating or exercising too much
- Have not started by 15 years of age.
- Occur more often than every 21 days or less often than every 45 days.
- Occur 90 days apart (even for one cycle).
- Last longer than 7 days.
- Cause you to change your pad or tampon more than normal (soaking more than 1 every hour for 2 to 3 hours in a row).
- Have large clots that are bigger than a quarter or are pouring out (flooding).
- Cause cramping pain that does not get better after taking OTC pain medicine. This pain may be so bad that you miss school or other activities.
To help with period disorders, your doctor or health care provider may ask questions about:
- Your period history
- When breasts and pubic hair started to develop
- Acne
- More than normal (excessive) hair growth
- Weight changes
- Eating/exercising habits
- Headaches
- Past medical history
- Family history
How Are Menstrual Period Disorders Treated?
Your doctor or health care provider will ask about your health and do a physical exam. They will usually feel your neck for the thyroid gland, check your skin for different changes and press on your belly. A pelvic exam is usually not needed, especially in young teens who are not having sex (sexually active).
Based on your history and exam, your doctor or health care provider may order lab work or imaging like a pelvic ultrasound. You may need different lab tests done depending on your condition. This may include an iron, thyroid and/or hormone tests.
Menstrual period problems are usually treated with hormonal medicines and/or OTC pain medicines. Your doctor or health care provider will help you choose a treatment plan that’s best for you!
