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Menstrual Irregularities

There aren't many young women who welcome their monthly menstrual periods, particularly if it comes with cramping and other physical discomforts. While the average teen knows that monthly menstruation is linked to the ability to conceive, most are not fully versed in just how that connection is important. As a result, most fail to seek appropriate medical advice when their periods may signal a reproductive problem.

While it is normal and expected that a young woman's menstrual period is irregular for up to the first two years after she first starts (menarche), some women remain very irregular. The following are indications that something may be wrong, and medical advice should be sought:

  • Your period occurs less than six times in a year
  • Period arrives much more often than approximately every month
  • Monthly bleeding often continuing for longer than a week
  • Bleeding is always very heavy and clotty
  • Unless you're using hormonal contraception (see below), bleeding that is always very scant, always brown, or lasts less than 3 days
  • Bleeding is always accompanied by severe pain
  • Regular, monthly discomfort symptoms without any bleeding

Dr. Sher adds that teens who have not yet started their periods shouldn't worry about that fact until around age 18, unless there are also no signs of secondary sexual characteristics (breast growth, pubic and axillary hair).

Awareness of your own cycle is the key. Some women who are diagnosed with PCOS (polycystic ovarian syndrome, a common cause of infertility and other health problems) in their adult years state that they probably have had the syndrome since their youth, but that they were not aware of the signs. The same may be said for premature ovarian failure, hyperprolactinemia, and other infertility-causing hormonal imbalances.

By the way, another important fact to know and remember through the years: chances are good that your menstrual cycle will change as you age. Specifically, your cycle may lengthen or shorten, become lighter or heavier, or take on other characteristics that span through several cycles. When occurring as the natural and expected result of a body's aging, these changes usually happen relatively gradually, say over a period of months or years. For this reason, you should not expect your currently always-regular cycle to be that way in ten or twenty years. It may be, or it may not. If such changes occur much more rapidly, say over the span of a few cycles, there may be cause for concern -- see a gynecologist.

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