Despite the many advances made in women’s health services, resources, and education over the years, there’s still a lot of confusion over what constitutes a “normal” period.

While the length and flow of menstrual cycles can vary widely from person to person, it’s important to know the basics—what to look for, what may require a visit to the ob/gyn, and what can be left alone.

Irregular Periods or Missed Periods

While missed periods can point to pregnancy, many other factors can cause this. Below are some of the most common causes of missed or irregular menstrual cycles.

  • Intense workouts — Intense exercise regimens can disrupt your menstrual cycle, or even cause it to stop altogether.
  • Rapid weight loss or gain — Extreme dieting, as well as sudden or extreme weight loss or gain for other reasons, can also result in missed periods.
  • Eating disorders — Anorexia and bulimia disrupt the body’s normal functions, leading to missed periods. If you or someone you know is struggling with an eating disorder, seek help
  • Taking the morning-after pill — Taking the morning-after pill can delay your period by about a week. If it’s been more than two or three weeks, take a pregnancy test.
  • Stress and anxiety — Your mental state doesn’t just affect your mind; it can also affect your body, resulting in disrupted menstrual cycles.
  • Breastfeeding — Breastfeeding after pregnancy often delays the return of the menstrual cycle.

These are just a few common causes of irregular or missed periods. Hormonal birth control, menopause, uterine fibroids, premature ovarian failure, polycystic ovary syndrome (PCOS), pelvic inflammatory disease (PID), certain illnesses, certain medications, drug and alcohol use, poor diet and nutrition, and very low body fat can all lead to disrupted periods.

If you’ve had unprotected sex and have missed your period, it’s a good idea to use an at-home pregnancy test.

Very Light Periods or Very Heavy Periods

Flow can vary widely from woman to woman; what you may consider extremely heavy may be normal for someone else. Very light or very heavy flows aren’t necessarily indicative of any kind of problem, but it’s a good idea to keep track of your flow and make note of any lifestyle shifts that seem to coincide with changes in flow.

Many women experience clumpy periods; these flows are comprised of blood clots and/or bits of tissue from the small vessels in the lining of the uterus, and generally they’re nothing to worry about if the clumps are no larger than a quarter and there are not very many of them.

As for the volume of your flow, trust your intuition, but don’t stress yourself out needlessly. If you notice your flow is much heavier or lighter than usual, it’s recommended that you meet with your doctor. While determining how heavy is “too heavy” can be tricky, here’s a good rule of thumb: If you’re changing your pad or tampon approximately every hour, it’s recommended that you consult your ob/gyn.

Period Pain

When menstruating, some women experience cramps, stabbing pains, nausea, and even diarrhea, back pain, and headaches. In many cases, these symptoms are normal.

However, if you’re experiencing severe, persistent pain that is interfering with your life and you’re not finding relief from standard remedies such as NSAIDs, heat packs, and rest, it’s recommended that you schedule a visit with your ob/gyn. If you have a fever or suddenly start experiencing period pain after the age of 25, this also warrants a trip to the doctor.

Very Long or Very Short Periods

Some women get their period for only a couple of days, while others’ periods may last a whole week. Neither is abnormal or necessarily cause for concern. In the first few years of menstruation, longer cycles are typical; over time, they tend to get shorter and more regular. Also, keep in mind that birth control, such as the pill and intrauterine devices, can affect the length of your cycle.

Remember, you know yourself best. If you usually have seven-day cycles and suddenly start having much shorter ones and have not made any recent lifestyle changes, a consultation with your ob/gyn is a smart idea.

Spotting Between Periods

Spotting between periods can be confusing—and inconvenient. For some women, spotting is quite common, and in fact most women experience some kind of spotting throughout their lifetime.

What exactly is the cause, though? Spotting often means nothing, but in some cases it can point to something else, such as:

  • Ovulation — Spotting caused by ovulation—when the ovaries release an egg—is usually light and lasts only one day, in the middle of your cycle. This doesn’t mean that you’re pregnant.
  • Implantation bleeding — After a sperm fertilizes an egg, the egg implants itself in the uterus, and this can cause spotting. If you’ve been trying to get pregnant, this could be a sign of success.
  • Uterine fibroids or polyps — These noncancerous growths in the uterus can cause pain and infertility, as well as spotting between periods.
  • STIs — Some sexually transmitted diseases (STDs) and sexually transmitted infections (STIs), particularly gonorrhea, can result in irregular bleeding.

Hormonal contraceptives, injuries, miscarriage, cancer, and breastfeeding can also lead to spotting.

While spotting can be disconcerting, you probably only need to see a doctor if it is very heavy, is accompanied by dizziness or pain, occurs more than once during the same cycle, lasts for more than a few days, or has a bad odor, or if you believe it may be caused by an injury or you have recently been the victim of rape. Finally, if you believe you could be pregnant, it’s best to consult a doctor.

Learn More

Have questions or concerns about your period? Reach out to the experts at Pacific Gynecology & Obstetrics Medical Group (PCOMG) today.