Abnormal Menstrual Periods

When you reach puberty, your ovaries make hormones (estrogen and progesterone) that cause your breasts to grow and your menstrual period to begin.

A part of your brain called the pituitary gland releases 2 hormones (FSH or follicle stimulating hormone and LH or luteinizing hormone) that tell your ovaries to release an egg. The egg travels towards your uterus. If the egg is not fertilized by sperm, the lining of your uterus (endometrium) is released through your vagina. This is called a menstrual period. Menstrual periods generally start around 12 years old, although some people will start younger or older.

• Happens every 21 to 45 days
• Lasts 7 days or less
• Requires 6 or less menstrual products, like pads or tampons per day
• Is the result of a rise and fall of hormones (estrogen and progesterone)
• Is associated with the release of an egg from your ovary (ovulation)

• An abnormal menstrual period is when you have bleeding that falls outside of the normal range for menstrual periods. This may mean that your bleeding is heavy, irregular or both.
• Sometimes, abnormal menstrual periods can lead to you losing a lot of blood and low levels of iron in your blood (iron-deficient anemia). If your menstrual periods are abnormal, you may need to see a healthcare provider.

Anovulation (AN-ov-yoo-lay-shun) means an egg is not being released, so the rise and fall of your hormones is not happening on a regular cycle, so your menstrual periods do not start and stop when they should.

These conditions may cause you to bleed more or longer than normal. Some of these bleeding disorders are caused by medicine or medical conditions. Some are because you have a family history of bleeding disorders.

Some signs that you may have a bleeding disorder include:

• Frequent nose bleeds
• Bleeding from your gums
• Blood in your stool
• Anemia
• Overflowing pads or tampons during your menstrual periods
• Passing blood clots larger than the size of a quarter with your menstrual period

Risk factors for abnormal menstrual periods include if you have:

• A bleeding disorder
• A relative with a bleeding disorder
• A hormone imbalance
• Very irregular menstrual periods, like several months between your menstrual periods

If your bleeding is very heavy or goes on for a long time, you may become very anemic (not have enough iron in your blood). In rare cases, anemia may be severe enough, you may need medicine, to go to a hospital or blood transfusions.

There are many different options for treatment of abnormal menstrual periods. The exact treatment depends on what is causing your abnormal bleeding. Most of the treatments involve hormones.

Some examples of treatments include:

• Birth control pills, that contain estrogen and progestin
• Birth control patches or rings
• Progestin intrauterine device (IUD)
• Progestin Implant (Nexplanon)
• Progestin injection (Depo Provera)
• Progestin hormone pills
• A non-hormonal pill that helps to decrease heavy bleeding called tranexamic acid (Lysteda)
• Iron supplement if you are anemic