Menstruation, or periods, usually begin around puberty, between the ages
of 9 and 14.
The average menstrual cycle lasts 23-35 days (counting from the first day
of one period to the next).
Some women may not have a regular cycle (number of days between periods).
This is normal, especially in the first 2 years after a woman's first period.
Most women have their period for about 6 days. Some may have it fewer than
6 days and some may have it for more than 6 days. This is normal.
Some women may have a large amount of blood flow while others have little.
Blood flow can vary. It is common to have heavy blood flow at the beginning
of a period and lighter blood flow at the end.
Blood flow may be heavy one period and light the next.
Dark clots of blood can be normal, especially on days when you have cramping
or heavy bleeding.
Most women have some mild cramps, discomfort, or tiredness during their
period. However, if these symptoms are severe, call the doctor.
Childbirth may change your symptoms (often improving them).
What causes cramps and discomfort?
During your period, you may have cramps or pain in your stomach or back.
You may have vomiting, nausea, diarrhea, constipation, a headache, or lightheadedness.
These symptoms may start a day or two before your period and last all or
some of your period.
Cramps are caused by contractions in your uterus as blood is pushed out.
Many women do not have cramps in the first few years of having their period,
but may experience them later.
If you have cramps, you do not necessarily have PMS. See "What is PMS?"
below.
What can I do about cramps?
Ibuprofen (such as Advil or Motrin) may help
ease pain.
Heating pads and warm baths may help ease cramps.
Some women feel better after exercising. Other women don't like exercising
when they have their period.
Eat healthy, drink plenty of fluids, and rest. Lying in the fetal position
(on your side with knees pulled close to your chest) may help.
Talk to your doctor if cramps are painful and these suggestions don't help.
The doctor may recommend an over-the-counter medication to ease blood flow
and cramps.
Doctors may prescribe birth control pills for women with severe symptoms.
What if I skip a period or my periods are too far apart?
If your periods are not regular, it could be due to diet, exercise, changes
in weight (especially weight loss), stress, illness, or eating disorders (such
as anorexia or bulimia).
It is normal to skip a period once in a while. This is especially common
in the first 2 years after your first period.
If you are having sexual intercourse, a missed period could be a sign of
pregnancy.
Check with your doctor if your periods are more than 35 days apart or if
you miss several periods. These symptoms could be a sign of pregnancy.
What if I bleed between periods or my periods are too close
together?
If you get your period every 2 or 3 weeks, it could be due to stress, exercise,
or changes in your life.
If your periods are less than 21 days apart, check with your doctor. The
doctor may want to test your blood to see if you are anemic. People who are
anemic need to eat more foods with iron.
Some women bleed a little bit between cycles, called "spotting." This can
be normal.
Spotting may be caused by an infection, such as a sexually transmitted disease.
Call your doctor.
What is PMS (premenstrual syndrome)?
PMS begins 1 or 2 weeks before a woman starts her monthly period and gets
better once her period has started.
Symptoms include mood swings (crying for no reason), tender breasts, muscle
pain, nausea, vomiting, swollen stomach, food cravings, weight gain, acne,
and feeling tired, tense, irritable, or depressed.
Many women have some of these symptoms, especially between the ages of 20
and 30.
If one or more of these symptoms cause you to change your daily routine
and activities, you may have PMS.
How is PMS treated?
You can help ease symptoms of PMS.
Eat smaller meals more often throughout the day to avoid bloating.
Eat at the same time each day.
Eat lots of carbohydrates and calcium, found in fruits, grains, vegetables,
and dairy products (such as milk).
Avoid salty foods, caffeine, and alcohol.
Exercise a few times a week.
Get plenty of rest.
Take deep breaths and practice relaxation techniques when you feel stressed.
(link to stress/relaxation here?)
Keep a record of your symptoms. Use a calendar or daily journal to write
down how you feel. Record if symptoms are mild, moderate, or severe. Look
for patterns and ways you can avoid or ease symptoms. Be sure to record the
day that you begin your period.
Call your doctor if symptoms are having great negative impact on your life
or health.
The doctor may prescribe medication. Recommendations will be different for
each woman.
What is toxic shock syndrome?
Toxic shock syndrome, or TSS, is caused by a bacterial infection in the
body.
It can happen to women who use tampons, although it is not clear why.
Women who use high-absorbency tampons are especially at high-risk.
Symptoms include vomiting, fever, chills, diarrhea, headache, sore throat,
difficulty breathing, confusion, weakness, thirst, rapid pulse, less urination,
strange or bad smelling discharge, and muscle aches. Within 24 hours, a blotchy,
red rash may appear.
TSS can also cause redness of the eyes, mouth, and vagina
You can reduce your risk of getting TSS by using both pads and tampons during
your period.
Use tampons with the lowest-absorbency as you can.
Change tampons often.
Store tampons away from heat and moisture to keep bacteria from growing.
Storing them out of the bathroom is best.
Wash your hands before and after using a tampon.
If you have symptoms of TSS, call your doctor immediately.
When should I call the doctor?
Call if you are 16 years or older and have not gotten your first period
or if you started developing breasts more than 3 years ago and have not gotten
your first period.
Call if your periods regularly come less than 23 days apart.
Call if your periods regularly come longer than 35 days apart.
Call if blood clots are bigger than a quarter.
Call if you bleed when you don't have your period.
Call if you have cramps that are painful.
Call your doctor if symptoms related to your period are having great negative
impact on your life or health.
Quick Answers
Every woman is different. The length of her period, her menstrual cycle,
and symptoms can all vary.
Many women have cramps during their period. Mild cramps are normal.
Ibuprofen, heating pads, and exercise may help ease cramps. Call the doctor
if pain is severe.
If your periods are not regular, it could be due to diet, exercise, changes
in weight (especially weight loss), stress, illness, or eating disorders (such
as anorexia or bulimia).
Some women bleed a little bit between cycles, called "spotting." This can
be normal but you should call your doctor if it happens often.
PMS includes many symptoms that begin 1 or 2 weeks before a woman starts
her monthly period and get better once her period has started. PMS affects
lifestyle and health.
Take steps to reduce symptoms of PMS by eating healthy, getting rest and
exercise, and avoiding salty food and caffeine.
Toxic shock syndrome, or TSS, is caused by a bacterial infection in the
body. It can happen to women who use tampons, although it is not clear why.
Call your doctor if symptoms related to your period are having great negative
impact on your life or health.
References
Center for Young Women's Health, Children's Hospital. Puberty and Menstrual
Cycles: Information Sheet. 4 February 2000 (cited 13 November 2001). Available
from: URL: http://www.youngwomenshealth..org/menstrual3.html
KidsHealth.org. Toxic Shock Syndrome. (cited 13 November 2001). Available
from: URL: http://www.kidshealth.org/Pagemanager.jsp?dn=KidsHealth&lic=1&ps=107&cat_id=article_set=23002
MayoClinic. What is Premenstrual Syndrome? 1 August 2000 (cited 13 November
2001). Available from: URL: http://www.mayoclinic.com/invoke.cfm?id=DS00134&printpage=true
ViaHealth.org. Women's Health: The Menstrual Cycle Overview. 11 May 2001
(cited 13 November 2001). Available from; URL: http://www.viahealth.org/disease/womenshealth/cycle.htm
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