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Definition
Menstrual bleeding (your period) is the monthly loss of blood that lines the uterus. It's a normal part of puberty.
Health Information
Cause
Your period starts between ages 8 and 16. Your first period comes a year or two after your breasts start to develop.
Menstrual bleeding is caused by changes in hormones. Hormones from the brain and ovaries make the lining of the uterus thicken. Reason: to prepare for a possible pregnancy.
When no pregnancy occurs, the blood lining the uterus breaks down and flows out the vagina.
If you are pregnant, you won't have menstrual bleeding.
Normal Menstrual Bleeding
Bleeding normally occurs every 21 to 35 days. On average, there will be 28 days between periods.
Bleeding normally lasts 3 to 7 days. It's normally less at the start, more in the middle, and less at the end.
Blood can be brown, dark red or bright red in color. There can be some small blood clots, often smaller than a quarter.
In the first year, periods can be irregular. The time between periods, how long they last, and how much blood flow occurs can change. This is normal in the first year.
Side Effects of Menstrual Bleeding
Cramps. Cramps are throbbing pain in the lower belly and back. You rarely get cramps in the first year of your period.
Gut Symptoms. Hormone changes can cause nausea or diarrhea.
Mood Changes. You may feel moody or tired during your period. These feelings are from normal hormone changes.
Anemia. Heavy bleeding can lead to low iron levels and anemia (low red blood cells). Anemia symptoms include fainting, dizziness or feeling more tired than usual.
Care Advice
Key Points
Your period is the normal monthly shedding of the lining of your uterus.
There are good options to manage your bleeding.
Here is some home care advice that should help.
Managing Menstrual Bleeding - Options
Many products absorb blood and allow you to continue normal activities while having a period. A mother, trusted family member, nurse or doctor can show you how to use:
Pads. Pads stick inside your underwear. Change your pad every 4 to 8 hours, or sooner if it is leaking.
Absorbable underwear. These have a built-in lining that absorbs menstrual blood. Change them every 12 to 24 hours. Wash them and reuse them.
Tampons. Tampons are inserted into your vagina. They come in a variety of sizes. Change the tampon every 4 to 8 hours, or sooner if it is leaking. Tampons are a good option while swimming.
Menstrual Cups. Flexible reusable cups inserted into the vagina to catch blood. Change the cup every 8 to 12 hours. Change it sooner if it feels heavy or leaks. Empty the cup, rinse it with water and put it back in.
Stay Active
It's important to go to school while having a period.
It's safe to take part in sports during a period.
It's fine to swim, bathe, or shower like normal during a period.
Manage Cramps
Cramping in the lower belly and back happens in more than 60% of girls. Cramps can last 2 or 3 days.
Use a heating pad or warm washcloth on the lower belly. Do this for 20 minutes, 2 times per day. A warm bath may also help.
Pain medicines can keep cramps to a mild level.
Ibuprofen is a very good drug for cramps. Advil and Motrin are some of the brand names. Follow package directions for dosing. No prescription is needed.
Ibuprofen should be started as soon as there is any menstrual flow.
When Bleeding is Too Heavy
Discuss with your doctor if any of the following occur.
Bleeding that lasts beyond 7 days.
More than 6 well-soaked pads or tampons per day.
Large blood clots occur (bigger than a quarter).
Periods occur more often than every 21 days.
What To Expect
In the first year of getting your period, your bleeding can vary in amount and frequency.
Cycles will become more regular after 1 to 2 years.
If bleeding becomes heavy, there are medications to help reduce the bleeding. Ask your doctor about them.
Call Your Doctor If
Bleeding is longer or heavier than usual
Severe pain
Feel faint or pass out
You think your teen needs to be seen
You have other questions or concerns
Author: Barton Schmitt MD, FAAP