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Page 1 of 2 Overview
Some women get through their monthly periods easily with few or no concerns. Their periods come like clockwork, starting and stopping at nearly the same time every month, causing little more than a minor inconvenience.
 However, other women experience a host of physical and/or emotional symptoms just before and during menstruation. From heavy bleeding and missed periods to unmanageable mood swings, these symptoms may disrupt a woman's life in major ways.
Most menstrual cycle problems have straightforward explanations and a range of treatment options exist to relieve your symptoms. If your periods feel overwhelming, discuss your symptoms with your health care professional. Once your symptoms are accurately diagnosed, he or she can help you choose the best treatment to make your menstrual cycle tolerable.
How the Menstrual Cycle Works
Your menstrual period is part of your menstrual cycle—a series of changes that occur to parts of your body (your ovaries, uterus, vagina and breasts) every 28 days, on average. Some normal menstrual cycles are a bit longer; some are shorter. The first day of your menstrual period is day one of your menstrual cycle. The average menstrual period lasts about five to seven days. A "normal" menstrual period for you may be different from what's "normal" for someone else.
Types of Menstrual Disorders
If one or more of the symptoms you experience before or during your period causes a problem, you may have a menstrual cycle "disorder." These include:
- Abnormal uterine bleeding (AUB): Excessive or heavy menstrual bleeding
- Amenorrhea: No menstrual bleeding
- Menstrual Cramps: Painful cramps caused by uterine contractions
- Fibroids: Noncancerous uterine tumors [there is no content related to this in the article]
- Dysmenorrhea: Painful menstrual periods [there is no content related to this in the article]
- Premenstrual Syndrome (PMS): Physical and emotional discomfort prior to menstruation
- Premenstrual dysphonic disorder (PMDD): Severe physical and emotional discomfort prior to menstruation
A brief discussion of menstrual disorders follows below.
Abnormal Uterine Bleeding
One in five women bleed so heavily during their periods that they have to put their normal lives on hold just to deal with the heavy blood flow.
Bleeding is considered heavy or abnormal if it interferes with normal activities. Blood loss during a normal menstrual period is about five tablespoons, but if you have AUB, you may bleed as much as 10 to 25 times that amount each month. You may have to change a tampon or pad every hour, for example, instead of three or four times a day.
Heavy menstrual periods can be common at various stages of your life—during your teen years when you first begin to menstruate and in your late 40s or early 50s, as you get closer to menopause.
If you are past menopause and experience any vaginal bleeding, discuss your symptoms with your health care professional right away. Any vaginal bleeding after menopause isn't normal and should be evaluated immediately by a health care professional.
Abnormal uterine bleeding can be caused by:
- Hormonal imbalances
- Structural abnormalities in the uterus
- Medical conditions
Many women with excessive menstrual bleeding can blame their condition on hormones. Your body may produce too much or not enough estrogen or progesterone—known as reproductive hormones—necessary to keep your menstrual cycle regular.
For example, many women with abnormal uterine bleeding don't ovulate regularly. Ovulation, when one of the ovaries releases an egg, occurs around day 14 in a normal menstrual cycle. Changes in hormone levels help trigger ovulation.
Certain medical conditions can cause abnormal uterine bleeding. These include:
- Thyroid problems
- Blood clotting disorders such as Von Willebrand's disease, a mild-to-moderate bleeding disorder
- Idiopathic thrombocytopenic purpura (ITP), a bleeding disorder characterized by too few platelets in the blood
- Liver or kidney disease
- Leukemia
- Medications, such as anticoagulant drugs such as Plavix (clopidogrel) or heparin and some synthetic hormones
Other gynecologic conditions that may be responsible for heavy bleeding include:
- Complications from the copper-T IUD
- Miscarriage
- Ectopic pregnancy, which occurs when a fertilized egg begins to grow outside your uterus, typically in your fallopian tubes
Other causes of excessive bleeding include:
- Fibroids (However, fibroids don't always cause excessive bleeding. In fact, about half of all women who have fibroids don't have any symptoms at all.)
- Infection
- Pre-cancerous conditions
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