Menstruation and the Menstrual Cycle
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Frequently Asked Questions
Menstruation
The rise and fall of levels of hormones
during the month control the men-
strual cycle.
and the Q: What happens during the men-
strual cycle?
Menstrual A: In the first half of the cycle, levels of
estrogen (the “female hormone”) start
to rise. Estrogen plays an important
Cycle
role in keeping you healthy, especially
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by helping you to build strong bones
1-800-994-9662 and to help keep them strong as you get
TDD: 1-888-220-5446 older. Estrogen also makes the lining of
Q: What is menstruation? the uterus (womb) grow and thicken.
A: Menstruation (men-STRAY-shuhn) This lining of the womb is a place that
is a woman's monthly bleeding. When will nourish the embryo if a pregnancy
you menstruate, your body sheds the occurs. At the same time the lining of
lining of the uterus (womb). Menstrual the womb is growing, an egg, or ovum,
blood f lows from the uterus through in one of the ovaries starts to mature.
the small opening in the cervix and At about day 14 of an average 28-day
passes out of the body through the cycle, the egg leaves the ovary. This is
vagina (see diagram on page 2). Most called ovulation.
menstrual periods last from 3 to 5 days. After the egg has left the ovary, it trav-
els through the fallopian tube to the
Q: What is the menstrual cycle? uterus. Hormone levels rise and help
prepare the uterine lining for preg-
A: When periods (menstruations) come
nancy. A woman is most likely to get
regularly, this is called the menstrual
pregnant during the 3 days before or
cycle. Having regular menstrual cycles
on the day of ovulation. Keep in mind,
is a sign that important parts of your
women with cycles that are shorter or
body are working normally. The men-
longer than average may ovulate before
strual cycle provides important body
or after day 14.
chemicals, called hormones, to keep
you healthy. It also prepares your body A woman becomes pregnant if the egg
for pregnancy each month. A cycle is is fertilized by a man’s sperm cell and
counted from the first day of 1 period attaches to the uterine wall. If the egg is
to the first day of the next period. The not fertilized, it will break apart. Then,
average menstrual cycle is 28 days long. hormone levels drop, and the thickened
Cycles can range anywhere from 21 to lining of the uterus is shed during the
35 days in adults and from 21 to 45 days menstrual period.
in young teens.
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U.S. Department of Health and Human Services, Office on Women’s HealthFrequently Asked Questions
The picture below shows the path the Q: What kinds of problems do
egg takes from the ovary, through the women have with their periods?
fallopian tube, and to the uterus. A: Women can have a range of problems
with their periods, including pain,
heavy bleeding, and skipped periods.
• Amenorrhea (ay-men-uh-REE-
uh) — the lack of a menstrual peri-
Fallopian tube od. This term is used to describe the
Ovaries absence of a period in:
• Young women who haven't start-
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ed menstruating by age 15
1-800-994-9662 Uterus
(womb) • Women and girls who haven't
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had a period for 90 days, even if
Cervix
they haven't been menstruating
Vagina
for long
Causes can include:
• Pregnancy
• Breastfeeding
• Extreme weight loss
Q: What is a typical menstrual • Eating disorders
period like?
• Excessive exercising
A: During your period, you shed the
thickened uterine lining and extra • Stress
blood through the vagina. Your period • Serious medical conditions in
may not be the same every month. It need of treatment
may also be different than other wom-
As above, when your menstrual cycles
en's periods. Periods can be light, mod-
come regularly, this means that impor-
erate, or heavy in terms of how much
tant parts of your body are working
blood comes out of the vagina. This is
normally. In some cases, not having
called menstrual f low. The length of
menstrual periods can mean that your
the period also varies. Most periods last
ovaries have stopped producing normal
from 3 to 5 days. But, anywhere from 2
amounts of estrogen. Missing these
to 7 days is normal.
hormones can have important effects
For the first few years after menstrua- on your overall health. Hormonal prob-
tion begins, longer cycles are common. lems, such as those caused by polycystic
A woman's cycle tends to shorten and ovarian syndrome (PCOS) or serious
become more regular with age. Most of problems with the reproductive organs,
the time, periods will be in the range of may be involved. It’s important to talk
21 to 35 days apart. to a doctor if you have this problem.
page
U.S. Department of Health and Human Services, Office on Women’s HealthFrequently Asked Questions
• Dysmenorrhea (dis-men-uh- Abnormal bleeding can have many
REE-uh) — painful periods, causes. Your doctor may start by check-
including severe cramps. Menstrual ing for problems that are most common
cramps in teens are caused by too in your age group. Some of them are not
much of a chemical called prosta- serious and are easy to treat. Others can
glandin (pros-tuh-GLAN-duhn). be more serious. Treatment for abnor-
Most teens with dysmenorrhea do mal bleeding depends on the cause.
not have a serious disease, even In both teens and women nearing
though the cramps can be severe. In menopause, hormonal changes can cause
older women, the pain is sometimes long periods along with irregular cycles.
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caused by a disease or condition such Even if the cause is hormonal changes,
as uterine fibroids or endometriosis. you may be able to get treatment. You
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For some women, using a heating should keep in mind that these changes
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pad or taking a warm bath helps ease can occur with other serious health
their cramps. Some over-the-coun- problems, such as uterine fibroids, pol-
ter pain medicines can also help with yps, or even cancer. See your doctor if
these symptoms. They include: you have any abnormal bleeding.
• Ibuprofen (eye-byu-PROH-
fuhn) (for instance, Advil, Q: When does a girl usually get her
Motrin, Midol Cramp) first period?
• Ketoprofen (key-toh-PROH- A: In the United States, the average age for
fuhn) (for instance, Orudis KT) a girl to get her first period is 12. This
does not mean that all girls start at the
• Naproxen (nuh-PROK-suhn) same age. A girl can start her period
(for instance, Aleve) anytime between the ages of 8 and 15.
If these medicines don’t relieve your Most of the time, the first period starts
pain or the pain interferes with work about 2 years after breasts first start to
or school, you should see a doctor. develop. If a girl has not had her first
Treatment depends on what’s causing period by age 15, or if it has been more
the problem and how severe it is. than 2 to 3 years since breast growth
• Abnormal uterine bleeding started, she should see a doctor.
— vaginal bleeding that’s different For help teaching your daughter about
from normal menstrual periods. It her changing body, visit http://www.
includes: girlshealth.gov/body/period/index.cfm
• Bleeding between periods for information on getting your period.
• Bleeding after sex
Q: How long does a woman have
• Spotting anytime in the menstru- periods?
al cycle
A: Women usually have periods until
• Bleeding heavier or for more days menopause. Menopause occurs
than normal between the ages of 45 and 55, usually
• Bleeding after menopause around age 50. Menopause means that a
woman is no longer ovulating (produc-
page
U.S. Department of Health and Human Services, Office on Women’s HealthFrequently Asked Questions
ing eggs) or having periods and can no • You suddenly get a fever and feel
longer get pregnant. Like menstruation, sick after using tampons.
menopause can vary from woman to
woman and these changes may occur
over several years.
Q: How often should I change my
pad and/or tampon?
The time when your body begins its
A: You should change a pad before it
move into menopause is called the
becomes soaked with blood. Each
menopausal transition. This can last
woman decides for herself what works
anywhere from 2 to 8 years. Some
best. You should change a tampon at
women have early menopause because
least every 4 to 8 hours. Make sure
http://www.womenshealth.gov of surgery or other treatment, illness,
to use the lowest absorbency tampon
1-800-994-9662 or other reasons. If you don’t have a
needed for your f low. For example, use
period for 90 days, you should see your
TDD: 1-888-220-5446 junior or regular tampons on the light-
doctor. He or she will check for preg-
est day of your period. Using a super
nancy, early menopause, or other health
absorbency tampon on your lightest
problems that can cause periods to stop
days increases your risk for toxic shock
or become irregular.
syndrome (TSS). TSS is a rare but
sometimes deadly disease. TSS is caused
Q: When should I see a doctor by bacteria that can produce toxins. If
about my period? your body can’t fight the toxins, your
A: See your doctor about your period if: immune (body defense) system reacts
and causes the symptoms of TSS (see
• You have not started menstruating
below).
by the age of 15.
Young women may be more likely
• You have not started menstruating
to get TSS. Using any kind of tam-
within 3 years after breast growth
pon puts you at greater risk for TSS
began, or if breasts haven't started to
than using pads. The Food and Drug
grow by age 13.
Administration (FDA) recommends
• Your period suddenly stops for more the following tips to help avoid tampon
than 90 days. problems:
• Your periods become very irregular • Follow package directions for inser-
after having had regular, monthly tion.
cycles. • Choose the lowest absorbency for
• Your period occurs more often than your f low.
every 21 days or less often than • Change your tampon at least every 4
every 35 days. to 8 hours.
• You are bleeding for more than 7 days. • Consider switching between pads
• You are bleeding more heavily than and tampons.
usual or using more than 1 pad or • Know the warning signs of TSS (see
tampon every 1 to 2 hours. below).
• You bleed between periods. • Don't use tampons between periods.
page • You have severe pain during your
period.
U.S. Department of Health and Human Services, Office on Women’s HealthFrequently Asked Questions
If you have any of these symptoms of • Vomiting
TSS while using tampons, take the • Dizziness and/or fainting
tampon out, and contact your doctor
right away: • Sunburn-like rash
• Sudden high fever (over 102 degrees) • Sore throat
• Muscle aches • Bloodshot eyes n
• Diarrhea
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1-800-994-9662
TDD: 1-888-220-5446
For more information
For more information about menstruation, contact womenshealth.gov at 1-800-994-
9662 or the following organizations:
Food and Drug Administration Association of Reproductive Health
Phone Number(s): (888) 463-6332 Professionals
Internet Address: www.fda.gov Phone Number(s): (202) 466-3825
Internet Address: http://www.arhp.org
American College of Obstetricians
and Gynecologists (ACOG) Resource Center for Young Women's Health
Center Phone Number(s): (617) 355-2994
Phone Number(s): (202) 638-5577; (202) Internet Address: http://www.youngwom-
863-2518 (for publications requests only) enshealth.org
Internet Address: www.acog.org
All material contained in this FAQ is free of copyright restrictions, and may be copied,
reproduced, or duplicated without permission of the Office on Women's Health in the
Department of Health and Human Services. Citation of the source is appreciated.
This FAQ was reviewed by:
Lawrence M. Nelson, M.D.
Investigator
National Institute of Child Health and Human Development
National Institutes of Health
Content last updated October 21, 2009.
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