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continued:

Menstrual cycle: What's normal, what's not

How can I track my menstrual cycle?

To find out what's normal for you, start keeping a record of your menstrual cycle on a calendar or with the help of a smartphone application. Begin by tracking your start date every month for several months in a row to identify the regularity of your periods.

If you're concerned about your periods, then also make note of the following every month:

  • End date. How long does your period typically last? Is it longer or shorter than usual?
  • Flow. Record the heaviness of your flow. Does it seem lighter or heavier than usual? How often do you need new sanitary protection?
  • Abnormal bleeding. Are you bleeding in between periods?
  • Pain. Describe any pain associated with your period. Does the pain feel worse than usual?
  • Other changes. Have you experienced any changes in mood or behavior? Did anything new happen around the time of change in your periods?

What causes menstrual cycle irregularities?

Menstrual cycle irregularities can have many different causes, including:

  • Pregnancy or breast-feeding. A delayed or missed period can be an early sign of pregnancy. Breast-feeding typically delays the return of menstruation after pregnancy.
  • Eating disorders, extreme weight loss or excessive exercising. Eating disorders — such as anorexia nervosa — extreme weight loss and increased physical activity can disrupt menstruation.
  • Polycystic ovary syndrome (PCOS). This common hormonal disorder can cause small cysts to develop on the ovaries and irregular periods.
  • Premature ovarian failure. Premature ovarian failure refers to the loss of normal ovarian function before age 40. Women who have premature ovarian failure — also known as primary ovarian insufficiency — might have irregular or infrequent periods for years.
  • Pelvic inflammatory disease (PID). This infection of the reproductive organs can cause irregular menstrual bleeding.
  • Uterine fibroids. Uterine fibroids are noncancerous growths of the uterus. They can cause heavy menstrual periods and bleeding between periods.

What can I do to prevent menstrual irregularities?

For some women, use of birth control pills can help regulate menstrual cycles. However, some menstrual irregularities can't be prevented.

Regular pelvic exams can help ensure that problems affecting your reproductive organs are diagnosed as soon as possible.

In addition, consult your health care provider if:

  • Your periods suddenly stop for more than 90 days — and you're not pregnant
  • Your periods become erratic after having been regular
  • You bleed for more than seven days
  • You bleed more heavily than usual or soak through more than one pad or tampon every hour or two
  • Your periods are less than 21 days or more than 35 days apart
  • You bleed between periods
  • You develop severe pain during your period
  • You suddenly get a fever and feel sick after using tampons

Remember, tracking your menstrual cycle can help you find out what's normal for you and what isn't. If you have questions or concerns about your menstrual cycle, talk to your health care provider.

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References
  1. What are menstrual irregularities? National Institute of Child Health & Human Development. http://www.nichd.nih.gov/health/topics/menstruation/conditioninfo/Pages/irregularities.aspx. Accessed Jan. 30, 2013.
  2. Menstruation and the menstrual cycle fact sheet. The National Women's Health Information Center. http://www.womenshealth.gov/publications/our-publications/fact-sheet/menstruation.cfm. Accessed Jan. 30, 2013.
  3. Menstruation and Menstrual Problems: Condition Information. National Institute of Child Health & Human Development. http://www.nichd.nih.gov/health/topics/menstruation/conditioninfo/Pages/default.aspx. Accessed Jan. 30, 2013.
  4. Polycystic ovary syndrome (PCOS) fact sheet. The National Women's Health Information Center. http://www.womenshealth.gov/publications/our-publications/fact-sheet/polycystic-ovary-syndrome.html. Accessed Jan. 30, 2013.
  5. Amenorrhea overview. National Institute of Child Health & Human Development. http://www.nichd.nih.gov/health/topics/amenorrhea/Pages/default.aspx. Accessed Jan. 30, 2013.
  6. Frequently asked questions. Especially for teens FAQ049. Your first period. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq049.pdf?dmc=1&ts=20130130T1559324907. Accessed Jan. 30, 2013.
  7. Welt CK. Evaluation of the menstrual cycle and timing of ovulation. http://www.uptodate.com/home. Accessed Jan. 30, 2013.
  8. Welt CK. Physiology of the normal menstrual cycle. http://www.uptodate.com/home. Accessed Jan. 30, 2013.
  9. Frequently asked questions. Gynecologic problems FAQ075. Ovarian cysts. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq075.pdf?dmc=1&ts=20130130T1601249662. Accessed Jan. 30, 2013.
  10. Frequently asked questions. Gynecologic problems FAQ077. Pelvic inflammatory disease. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq077.pdf?dmc=1&ts=20130130T1602481391. Accessed Jan. 30, 2013.
  11. De Silva NK, et al. Definition and evaluation of abnormal uterine bleeding in adolescents. http://www.uptodate.com/home. Accessed Jan. 30, 2013.
  12. What causes menstrual irregularities? http://www.nichd.nih.gov/health/topics/menstruation/conditioninfo/Pages/causes.aspx. National Institute of Child Health & Human Development. Accessed Jan. 30, 2013.
  13. What are the common treatments for menstrual irregularities? National Institute of Child Health & Human Development. http://www.nichd.nih.gov/health/topics/menstruation/conditioninfo/Pages/treatments.aspx. Accessed Jan. 30, 2013.
  14. Other FAQs. National Institute of Child Health & Human Development. http://www.nichd.nih.gov/health/topics/menstruation/conditioninfo/Pages/faqs.aspx. Accessed Jan. 30, 2013.
  15. Carusi DA, et al. The gynecologic history and physical examination. http://www.uptodate.com/home. Accessed Jan. 31, 2013.
  16. Frequently asked questions. Gynecologic problems FAQ013. Endometriosis. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq013.pdf?dmc=1&ts=20130131T1105087711. Accessed Jan. 31, 2013.
  17. Frequently asked questions. Gynecologic problems FAQ074. Uterine fibroids. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq074.pdf?dmc=1&ts=20130131T1108533843. Accessed Jan. 31, 2013.
  18. Nelson LM, et al. Clinical manifestations and evaluation of spontaneous primary ovarian insufficiency (premature ovarian failure). http://www.uptodate.com/home. Accessed Jan. 31, 2013.
  19. Kaunitz AM. Hormonal contraception for suppression of menstruation. http://www.uptodate.com/home. Accessed Feb. 5, 2013.
MY01541 April 16, 2013

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