Periods Pains Menstruation

Periods and Period Problems

A period is the part of the menstrual cycle when women bleed from their vagina for a few days. For most women this happens every 28 days or so, but it’s common for periods to start sooner or later than this, ranging from day 21 to day 40. Period usually last for about 5 days, but it can vary between 3 and 8 days.

The bleeding tends to be heaviest in the first 2 days. When period is at its heaviest, the blood will be red. On lighter days, it may be pink, brown or black. A normal woman loses about 30 to 72 milliliters (5 to 12 teaspoons) of blood during the period, although some women bleed more heavily than this.

Read more about heavy periods, period pain, irregular periods and stopped or missed periods.

When do periods start ?

Periods usually start to occur around the same time as other changes happen to the body at the time of puberty, such as starting to develop breasts or to grow pubic hair. Eleven years is the average age for puberty to start in girls. A girl’s monthly periods usually begin at around the age of twelve, but it is normal to start at any time between the ages of 9 and 15. A delay in starting periods isn’t usually a cause for concern. Most girls will have regular periods from age 16 to 18.

Sanitary products

Sanitary products absorb or collect the blood released during your period. The main types of sanitary products are

  • Sanitary pads are strips of padding that have a sticky side you attach to your underwear to hold them in place. One side of the pad is made of a special absorbent material that soaks up the blood.
  • Pantyliners are a smaller and thinner type of sanitary pad that can be used on days when your period is very light.
  • Tampons are small tubes of cotton wool that you insert into your vagina to absorb the blood before it comes out of your body. There’s a string at one end of the tampon, which you pull to remove it.

Changes in periods

Periods can change, they may last longer or get lighter. This doesn’t necessarily mean there’s a problem, but it does need to be investigated. consult your gynecologist if you observe abnormal changes. Bleeding between periods, bleeding after having sex, or bleeding after the menopause needs to be checked by a gynecologist. It might be caused by an infection, abnormalities in the neck of the womb (the cervix) or, in rare cases, it could be cancer.

You could be pregnant if you miss a period and you’ve had sex. Consult your gynecologist if you’ve taken a pregnancy test and the result is negative (you’re not pregnant) and you’ve missed 3 consecutive periods. She or he will investigate the cause and recommend any necessary treatment.

Getting pregnantBest Ovulation Calculator Ovulation Calendar

Working out when you can get pregnant, what is your fertile period – can be difficult. It’s around the time you ovulate, which is about 12 to 14 days before the start of your next period. But sperm can survive inside a woman’s body for days before ovulation occurs. This means your fertile time extends back earlier in your cycle. (for more details see “Understanding Ovulation and Fertile Period“)

You can calculate when your period will start and your peak ovulation times using this advanced ovulation calculator.

You can’t get pregnant if you don’t ovulate. Some hormonal methods of contraception, such as the combined pill, contraceptive patch and contraceptive injection, work by preventing ovulation.

When do periods stop ?

Your periods will continue until you reach the menopause, which usually occurs when you are in your late 40s to mid-50s. The average age of U.S. women at the time of menopause is 51 years. The most common age range at which women experience menopause is 48-55 years. Premature menopause is defines as menopause occurring in a woman younger than 40 years.

Your periods may start to become less frequent over a few months or years before stopping altogether. In some cases they can stop suddenly. (Read more about “Menopause“)

What Are Menstrual Problems ?

Menstrual cycles often bring about a variety of uncomfortable symptoms leading up to your period. Premenstrual syndrome (PMS) encompasses the most common issues, such as mild cramping and fatigue, but the symptoms usually go away when your period begins.

However, other, more serious menstrual problems may also occur. Menstruation that is too heavy or too light, or the complete absence of a cycle, may suggest that there are other issues that are contributing to an abnormal menstrual cycle.

A “normal” menstrual cycle means something different for every woman. A cycle that’s regular for you may be abnormal for someone else. It’s important to keep track of your menstrual cycle and to talk to your doctor if you notice any significant changes.

Following are several different menstrual problems that you may experience.

Premenstrual syndrome (PMS)

PMS is thought to be linked to changing levels of hormones throughout the menstrual cycle. Not all women experience PMS. Among those who do, the range and severity of symptoms can vary. Symptoms may include:

  • mood swings
  • feeling depressed or irritable
  • headaches
  • tiredness
  • bloating
  • breast tenderness

Symptoms appear and can intensify during the second half of your menstrual cycle, and then ease and disappear after your period starts. (For more details see “Premenstrual syndrome – PMS“)

Painful periods

Pain during periods is common. It’s caused by the womb contracting to push out the blood. Exercise may help relieve the pain, as well as taking over-the-counter painkillers, such as paracetamol or ibuprofen. Consult your doctor if the pain is so severe that it affects your daily life. Hormonal contraception (such as the combined pill, the intrauterine system (IUS), the contraceptive patch or the contraceptive injection) can reduce period pain.

Heavy periods

Some women naturally have heavier periods than others, but if your periods are so heavy that they impact your life, talk to your doctor about your bleeding, including how often you have to change your sanitary protection (towels, tampons or menstrual cup). (Read more about “Abnormal Uterine Bleeding”)

Irregular periods

A period normally lasts two to seven days, with the average period being five days long. The length of the menstrual cycle varies from woman to woman, but the average is to have periods every 28 days. Regular cycles that are longer or shorter than this, from 21-40 days, are normal. But some women have an irregular menstrual cycle.

This is where there is a wide variation in:

  • the time between your periods (they may arrive early or late)
  • the amount of blood you lose (periods may be heavy or light)
  • the number of days the period lasts

Irregular periods can be common during puberty and just before the menopause. Changing your method of contraception can also disturb your normal menstrual cycle.

Stopped or missed periods

There are many reasons why a woman may miss her usual monthly period, or why periods may stop altogether. Most of the time the cause is nothing to worry about. Some common reasons are:

  • pregnancy
  • sudden weight loss
  • stress
  • extreme over exercising
  • being overweight or obese
  • reaching the menopause

If you periods stop and you’re concerned, see your doctor.


Endometriosis is a condition where tissue that behaves like the lining of the womb (endometrium) is found in other areas of the body, such as the ovaries and fallopian tubes. Not all women have symptoms, but endometriosis can cause:

  • painful, heavy or irregular periods
  • pelvic pain
  • pain or discomfort when going to the toilet
  • pain during or after sex
  • feeling tired all the time
  • bleeding from your bottom

See your gynecologist if you have symptoms of endometriosis, especially if they’re impacting on your life.

Ovulation pain

Some women get a one-sided pain in their lower abdomen when they ovulate. The pain can be a dull cramp or a sharp and sudden twinge. It can last just a few minutes or continue for a day or two. Some women notice a little vaginal bleeding when it happens.

Painful ovulation can usually be eased by simple remedies like soaking in a hot bath or taking an over-the-counter painkiller, such as paracetamol.


Dr Sobia Mohyuddin

MCPS, FCPS, MRCOG, Consultant Obstetrics & Gynaecology

Doctor Sobia Mohyuddin is a highly skilled and experienced Obstetrician and Gynecologist, with 25 years of training and experience in renowned, large institutions. She holds the position of Associate Professor and Fellow at the College of Physicians and Surgeons Pakistan. She is also a member of the Royal College of Obstetricians and Gynecologists (UK).