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.
Remember that 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 stay in tune with your body and to talk to your doctor if you notice any significant changes to your menstrual cycle.
There are several different menstrual problems that you may experience.
PMS occurs one to two weeks before your period begins. Some women experience a range of physical and emotional symptoms. Others experience few symptoms or even none at all. PMS can cause:
- breast soreness
- food cravings
- excessive fatigue
- feelings of stress
- mild stomach cramps
You may experience different symptoms every month, and the severity of these symptoms can also vary. PMS is uncomfortable, but it’s generally not worrisome unless it interferes with your normal activities.
Another common menstrual problem is a heavy period. Also called menorrhagia, heavy periods cause you to bleed more than normal. You may also have your period for longer than the average of five to seven days.
Menorrhagia is mostly caused by imbalances in hormone levels, especially progesterone and estrogen.
Other causes of heavy or irregular menstrual bleeding include:
- vaginal infections
- inflammation of the cervix
- underactive thyroid gland (hypothyroidism)
- noncancerous uterus tumors (fibroids)
- changes in diet or exercise
In some cases, women may not get their period. This is called amenorrhea. Primary amenorrhea is when you don’t get your first period by age 16. This may be caused by an issue with the pituitary gland, a congenital defect of the female reproductive system, or a delay in puberty. Secondary amenorrhea occurs when you stop getting your regular periods for six months or more.
Common causes of primary amenorrhea and secondary amenorrhea in teens include:
- overactive thyroid gland (hyperthyroidism)
- ovarian cysts
- sudden weight gain or loss
- stopping birth control
When adults do not menstruate, the common causes are often different. These may include:
- premature ovarian failure
- pelvic inflammatory disease (a reproductive infection)
- stopping birth control
A missed period could mean that you’re pregnant. If you suspect you may be pregnant, be sure to take a pregnancy test.
Not only can your period be lighter or heavier than normal, but it can also be painful. Cramps are normal during PMS and they also occur when your uterus contracts as your period begins. However, some women experience excruciating pain. Also called dysmenorrhea, extremely painful menstruation is likely linked to an underlying medical problem, such as:
- pelvic inflammatory disease
- abnormal tissue growth outside of the uterus (endometriosis)