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Published in Menstruation on Apr 27th 2023

Is My Period Normal? Five Symptoms to Watch Out For

Menstrual periods are different for every person. Sometimes they last a few days; other times, it may take up to a full week before a person’s cycle is complete. From a light menstrual flow that is barely noticeable to a heavy period with severe cramps, it’s all considered normal. However, there are exceptions, such as when your period is inconsistent, or you notice any changes during your monthly cycle. Below are some specific symptoms to keep your eye on that could present a potential problem and prompt you to see your gynecologist.

1. Heavy Bleeding

Heavy or lengthy menstrual bleeding is called menorrhagia, which may occur secondary to a uterine condition or a hormonal imbalance. Menorrhagia is characterized by specific parameters, including:

• A period lasting over seven days
• Passing large blood clots (over the size of a quarter)
• The need to change your tampon or pad within two hours or during the night

2. Bleeding Between Periods

If you experience any type of bleeding between periods – including spotting – it may present a reason for concern. Bleeding between periods could be caused by several conditions, including:

• Hormonal changes (caused by perimenopause, menopause, or puberty)
• Benign uterine cysts
• Cervical cysts
• Pelvic inflammatory disease (PID)
• Endometriosis
• Changes in hormone levels, such as during puberty, perimenopause, and menopause
• Cervical, ovarian, or uterine cancer (in rare instances)

3. Missing Periods

There are several factors known to disrupt the menstrual cycle, such as:

• Too much exercise
• Eating disorders (e.g., anorexia)
• Extreme, long-term stress
• Some forms of contraceptives
• Sudden weight loss
• Pregnancy
• Breastfeeding
• Menopause
• Polycystic ovary syndrome {PCOS}

When the underlying cause of disrupted menstrual cycles is temporary, the cycle usually returns to normal the following month. Amenorrhea is when periods are missed outside of menopause. A person has amenorrhea when they miss more than three consecutive periods, or they have not had a period by age 15.

4. Irregular Periods

The menstrual cycle usually lasts 28 days but can vary in length from person to person and from cycle to cycle. A cycle that lasts for 24 to 38 days is considered normal. An irregular period can be described as:

• When your period comes early, late, or does not come at all
• When the length of your cycle suddenly changes
• Periods occurring less than 21 or more than 35 days apart
• Missed periods for three+ months in a row
• Menstrual bleeding that is much lighter or much heavier than usual

5. Premenstrual Dysphoric Disorder (PMDD)

Premenstrual dysphoric disorder {PMDD} is a severe form of premenstrual syndrome (PMS) that typically requires medical intervention. Often, lifestyle changes along with certain medications are used to help alleviate the symptoms. PMDD symptoms begin the week before the menstrual cycle starts. The symptoms continue until a few days after the period begins. Common symptoms of PMDD include:

• Psychological symptoms, such as agitation, anxiety, paranoia, anger, lack of control, depression, severe fatigue, and poor self-image
• Physical symptoms, such as fluid retention, insomnia, weight gain, respiratory problems, swelling, allergies, infections, visual changes, nausea, vomiting, constipation, heart palpitations, muscle spasms, and pelvic pressure
• Skin problems, such as inflammation, itching, acne, and cold sores
• Neurologic symptoms, such as fainting, dizziness, prickling, and tingling sensations in the legs and arms
• Hormonal symptoms, such as painful menstruation, appetite changes, food cravings, and hot flashes

It’s important to note that not everyone experiences all of the symptoms of PMDD; the symptoms can vary from person to person, but you must have at least five qualifying symptoms to be diagnosed with the disorder.

Learn More About Your Irregular Periods

Menstrual cycles that are unusually long or short, or those that vary in duration from month to month, could indicate an underlying health problem, so it’s essential to report these symptoms to your doctor. Schedule an appointment with Pacific Women’s Obstetrics and Gynecology to talk to a gynecologist about abnormal period symptoms.