Periods

A period is a bleed from the uterus (womb) that is released through the vagina. It happens approximately every 28 days, although anywhere between 24-35 days is common. A period is part of a women's menstrual cycle.

It is possible for your periods to begin between the ages of 8-16 years, but they most commonly start around the age of 12. Your periods will continue until the menopause, which usually occurs between 45 -55 years of age.

As a baby girl, you are born with all your eggs stored in follicles (sacs) in your ovaries. As puberty begins, your body starts to produce hormones, such as oestrogen, and progesterone that cause your eggs to mature. This is the beginning of your first menstrual cycle.

Having periods is part of the female reproductive cycle. Your cycle begins on the first day of bleeding and continues up to, but not including, the first day of your next period.

Different amounts of each of the female hormones are produced by your body at different times during your cycle. As a result, lots of bodily changes occur throughout your cycle. For example, you may develop swollen breasts, and/or have mood changes. Your basal body temperature (your temperature first thing in the morning) will also change depending on which point you are at in your cycle.

During the reproductive cycle, hormones released by the pituitary gland, in your brain, stimulate your ovaries. As a result, some of the eggs stored in the follicles of your ovaries begin to grow and mature. These follicles start to produce the hormone oestrogen and, as a result, the oestrogen level in your bloodstream rises. This causes your womb lining to thicken in preparation for receiving a fertilised egg.

If you have recently had sex (within several days of the egg being released) and there are sperm in your fallopian tube, then the egg may become fertilised. However, if there are no sperm to fertilise the egg, your oestrogen and progesterone levels will decrease and the endometrium (the womb lining) will start to break down. This marks the start of your period.

Your period is made up of the endometrium and a small amount of blood. The blood comes from the breaking of fine blood vessels within the womb as the lining detaches itself.

Some women have few or no symptoms during their period. Bleeding can last up to eight days, although it often lasts about five days, with the bleeding heaviest during the first two days.

During your period, your blood flow may appear heavy, but the actual amount of blood lost is only normally enough to fill between 5-12 teaspoons. However, in some cases you may experience heavier than normal periods. This is known as menorrhagia and there are a number of medications that can be used to treat it. (see the health encyclopaedia topic about 'menorrhagia').

The cycle of your hormones may affect you both physically and emotionally. In the days leading up to your period, you may experience symptoms of premenstrual syndrome. These include:

- headaches,
- bloating,
- irritability,
- backaches,
- feeling depressed,
- a general feeling of being upset or emotional,
- difficulty sleeping,
- difficulty concentrating,
- breast tenderness, and
- some weight gain (up to 1kg)

Once your period has started, these symptoms should improve, and when your period has ended, they should disappear altogether.

Periods can sometimes be painful. The precise cause of painful periods is unknown, although women who produce high levels of the hormone, prostaglandin, or who are more sensitive to the hormone, tend to have painful periods. You may experience pain in your abdomen, back or vagina. It usually starts shortly before your period begins and last for a few days. Painkillers, such as non-steroidal anti-inflammatory drugs (NSAIDs) can be used to treat painful periods (see the health encyclopaedia topic about 'painful periods').

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Painkillers

To relieve the discomfort of your period, you can take painkillers. Paracetamol, ibuprofen, and aspirin can be particularly effective at blocking the hormone prostaglandin which can cause pain. Make sure that you follow the instructions on the packet carefully, and stick to the recommended daily dosage. Those under 16 years of age should not take aspirin.

Contraception

Using the contraceptive pill can sometimes ease the pain of periods. This is because it thins the lining of the uterus and, as a result, the amount of prostaglandin released in the body is decreased. An intra-uterine system (IUS) is another form of contraception that may help relieve painful periods.

Other treatment methods

If you do not like the idea of using medication to ease period pain, a transcutaneous electrical nerve stimulation (TENS) machine is a possible alternative option. The device works by work by giving out a small electrical current that interferes with the nerve's pain signals. However, you cannot get these on the NHS.
Exercise is often a good, natural way to ease pain. Gentle walking, swimming or cycling can sometimes be effective.

Relaxation techniques, such as meditation, breathing exercises, and massages, can sometimes be useful ways of relieving period pain. Activities, such as yoga, or meditation, can be effective forms of stress relief.

Holding a covered hot water bottle against your abdomen, or back, may be a useful way of reducing discomfort. Having a warm bath may also be soothing.

Heavy and irregular periods

If you have heavy or irregular periods, there are a number of different treatment options available to you, depending on the cause. You should speak to you GP about the possible options. You can also find more information about 'heavy periods' and 'irregular periods' in the separate health encyclopaedia topics about these conditions.

Sometimes, you may experience problems with your period. For example, you may get:

heavy periods (menorrhagia),
painful periods (dysmenorrhoea),
irregular periods,
polycystic ovary syndrome (PCOS), or
you may not have any periods at all (amenorrhoea).
Heavy periods (menorrhagia)

The amount of blood lost during a period varies from woman to woman. As a result, it is very hard to diagnose menorrhagia. If you feel that your periods are so heavy they are causing disruption to your everyday life and making you feel miserable, you should visit your GP. You may have heavy periods if you are using excessive amounts of tampons, or sanitary towels, if you experience flooding through your clothes, or you need to use a sanitary towel and a tampon to prevent through. See the health encyclopaedia topic about 'heavy periods' for more information.

Painful periods (dysmenorrhoea)

Painful periods, also known as dysmenorrhoea, can cause symptoms before and during your periods. The pain normally affects your lower abdomen and it can sometimes spread to your pelvis, lower back, and thighs. Your GP will be able to prescribe medication to help ease the pain, and may also be able to provide you with advice about possible non-medication treatments. See the health encyclopaedia topic about 'painful periods' for further information.

Irregular periods

Periods can last anywhere between 2-8 days. If you have irregular periods, there will be variations in the gap between your periods, the amount of blood lost, and the duration of the bleeding. There are many possible causes of irregular periods, and treatment will depend on the underlying cause. Possible treatments include relaxation classes, counselling and changing your current contraceptive pill. For more information, see the health encyclopaedia topic about 'irregular periods'.

Polycystic ovarian syndrome (PCOS)

Polycystic ovarian syndrome (PCOS) is a condition which is associated with multiple cysts in your ovaries. It can cause problems with getting pregnant, acne, weight gain, excessive hair growth and irregular, or light periods. It can be treated with weight loss, anti-male hormone drugs, hormone treatments or a medicine called metformin. For more information, see the health encyclopaedia topic about 'polycystic ovarian syndrome'.

Absent periods (amenorrhoea)

Sometimes, a woman may stop having periods altogether. In the majority of cases, this also means that no eggs are produced. There are many possible causes of amenorrhoea. These include doing excessive exercise, stress, various medications and polycystic ovarian syndrome (PCOS). The treatment for this will vary depending on what has caused your periods to stop. Sometimes, hormone replacement therapy can be used. See the health encyclopaedia topic about 'absent periods' for more information.

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