Bleeding between periods
Bleeding between periods or after sexual intercourse is not a normal part of having periods, so see a doctor if you experience this.
Only under the following circumstances is it normal not to have periods:
- before you reach puberty
- when you are pregnant
- if you are breastfeeding (however, breastfeeding doesn't necessarily prevent pregnancy)
- if you have reached menopause
- take the combined oral contraceptive hormone pills every day (missing the 7 non-hormonal pills in the packet).
If you have no periods, but you should, it is known as amenorrhoea. There are 2 categories of amenorrhoea:
- primary amenorrhoea – your periods never started and you are 15 years or older.
- secondary amenorrhoea – you started having periods, but they stopped for 6 months or more.
Amenorrhoea may be caused by:
- strenuous exercise
- some medications, including the oral contraceptive pill (it can take 3–6 months to start having normal periods again after stopping the pill)
- chronic illness
- problems with your ovaries
- hormonal imbalances such as polycystic ovarian syndrome, issues with the functioning of your thyroid gland, hypothalamus (the part of your brain that helps regulate your menstrual cycle) or pituitary gland
- anatomical problems with your uterus, cervix or vagina
- the absence of puberty
- depression and some other forms of mental illness
- low body weight.
If your lack of periods is due to not ovulating (releasing an egg), you may find it difficult to get pregnant. You may also be at risk of osteoporosis (weak bones).
See your doctor if you are not having periods (except for the reasons listed above as normal). There are different treatment options available, depending on the cause of your amenorrhea.
Menorrhagia is the term given to periods that are long and heavy. It affects around 20–25% of women. Menorrhagia may involve periods that are prolonged (lasting for longer than 7 days), and/or excessive bleeding with flooding or clots.
- Women with menorrhagia may lose 80 ml or more of blood per period, compared with the 30–40 ml lost by most women.
- If you are changing your tampon or sanitary pad more often than every hour, flooding (soaking through your pads/clothing) or becoming anaemic, this is a good indication you have menorrhagia.
It is one of the main reasons for having a hysterectomy (removing the uterus with surgery), although there are other less extreme treatments to try first such as a Mirena (a type of intrauterine device also used for contraception). Read more about heavy periods.
Some women have painful periods. Dysmenorrhoea is the term given to periods that are more painful than expected ‘normal’ discomfort. This may just be a symptom of your period or a sign of an underlying condition, such as endometriosis. Read about painful periods.