During menstruation, the lining of the uterus is shed through the vagina as menstrual bleeding. The flow typically lasts between 2 and 8 days, with an average duration of 5 days. The amount of menstrual bleeding is very individual, and small clots in the blood are common. Many people also have light spotting before or immediately after their period. However, sometimes the amount of menstrual flow or how often the period occurs is not typical.
Sometimes the flow can be very heavy. If you have to change your sanitary protection e.g. every 1 to 2 hours or have to get up several times a night to change your protection, or if even large menstrual protectors that are changed regularly are not enough, you should seek medical advice. There can be many reasons for heavy periods, but the most common cause is myomas. Endometriosis and adenomyosis can also cause heavy menstrual bleeding and other flow disturbances. Read more about endometriosis and adenomyosis here.
Heavy periods can sometimes cause your haemoglobin to drop. People with heavy periods should, therefore, make sure they get enough iron. Various hormone medications, such as combined contraceptive pills or IUDs containing progesterone, often help to control menstrual bleeding. The different options can be discussed with a health professional.
An irregular or absent menstrual cycle
The menstrual cycle starts on the first day of your period and ends on the first day of the following period. The length of the menstrual cycle is usually between 23 and 35 days. For most people, the length of their menstrual cycle varies, and there can be a difference of a few days or even a week in the cycle length.
Sometimes, however, the menstrual cycle can be very irregular, or menstruation can be notably infrequent or frequent, and sometimes there is no menstrual cycle at all. Various menstrual disorders are quite common, and many causes can contribute to irregular menstrual cycles. For example, being ill or stressed or over-exercising can affect your periods.
If you miss your period, it is important to rule out the possibility of pregnancy. However, if pregnancy is not a possibility and you are worried about your situation, you should talk to a health professional.
Completely absent periods, long or irregular menstrual cycles, or prolonged bleeding can also sometimes be caused by PCOS, or polycystic ovary syndrome. PCOS differs from the more common polycystic ovary syndrome, PCO, because PCOS is also associated with hormonal disorders. Read more about PCOS here.
Between periods, you may experience bloody spotting. This type of bleeding is called breakthrough bleeding. It is a good idea to discuss the cause of the bleeding with a healthcare professional, although often it does not require treatment.