Are your periods normal?

Good Housekeeping online 25.07.2008

If you're worried about changes to your monthly cycle our simple guide will help you work out what's going on

calendar with the 25th marked in red Knowing whether your periods are normal or not can help alert you to potential health problems, particularly as you get older.

The length and heaviness of a period varies dramatically from one woman to another - and may vary enormously from one period to the next. So deciding whether your periods are heavier than normal can be difficult, but doctors use the following indicators:

Needing to use a sanitary towel as well as a tampon to cope with bleeding

Passing small clots for more than one or two days

Flooding - the sudden, unexpected onset of a period, like turning on a tap

Regularly finding that your menstrual cycle lasts more than 8-10 days

Bleeding so heavily it interferes with work and social activities

If further investigations rule out any underlying medical cause, heavy periods may be treated in a variety of ways. Non-hormonal treatments include NSAIDs (non-steroidal anti-inflammatory drugs), which can reduce blood loss.

Hormonal treatments include the combined oral contraceptive pill, which suppresses ovulation and reduces bleeding, progestogen tablets or an IUD such as a Mirena (a coil containing a synthetic form of progesterone), which suppresses the growth of the womb lining to reduce or stop bleeding.

Surgical options include endometrial ablation, which destroys the layer of cells lining the uterus to produce a ‘normal' or light level of bleeding. A hysterectomy really should be the final resort.

How age affects your periods

In your 30s
Your periods should be spaced about 28 days apart as the body still ovulates regularly. There shouldn't be any significant changes to your periods from when you were in your 20s, especially if you haven't had children, although the pill may make them lighter and less painful.
Warning signs Changes to your period, heavier bleeding and mid-cycle bleeding should be investigated. Endometriosis becomes more common in women in their mid-30s and is a condition where cells from the womb lining implant outside the uterus, causing irregular or heavier periods. Fibroids - benign swellings in the uterus wall - can also develop, usually after the age of 35. Watch out for heavier periods, the sensation of a lump or bladder problems.

In your 40s
There will be some alteration to your body's hormonal system and by your mid to late 40s the lining of the uterus may start to thicken in preparation for the menopause. Periods may also become heavier and more irregular after childbirth as the uterus becomes bulkier and the lining thickens.
Warning signs Although you may experience some natural changes after childbirth, heavy bleeding and pain could indicate fibroids or endometriosis, although after childbirth your chances of developing endometriosis are reduced.

In your 50s
As the body approaches the menopause, the ovaries stop releasing eggs and less oestrogen and progesterone are produced. You can expect erratic, heavier periods that become further and further apart. The average age for the menopause is now 51.
Warning signs Any bleeding after the menopause (dated as one year after your final period) needs to be checked out, as does regular bleeding between periods, even during the menopause. Fibroids may cause heavier bleeding. Uterine polyps - soft, non-cancerous growths that attach to the uterus - also become more common after the menopause. Endometrial cancer (cancer of the womb) is most common in women aged between 50 and 70 and one in five women is diagnosed while going through the menopause. Warning signs to watch out for are unusually heavy bleeding, bleeding between periods, post-menopausal bleeding and a watery pink or dark, foul-smelling vaginal discharge.

The answers to specific problems may not apply to everyone and are not substitutes for professional medical advice. If you're worried, see your GP. For more information, visit www.netdoctor.co.uk