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Women’s health centre

Menstrual cycle - Period problems

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If problems with your periods are they're affecting your life, there's help and support available. Find out more about treating painful periods, heavy periods, PMS and what to do if you're having no periods.

Most women have a regular menstrual cycle that's around 28 days long (28 days from the start of one period to the start of the next), and they bleed for three to seven days each cycle. However, some women experience problems with their periods.

Before you see your doctor about period problems, it can be useful to keep a diary of your symptoms throughout the menstrual cycle. This can help you give your doctor a detailed idea of what happens, and when, during your cycle.

You can read this whole article, or click on the links to go straight to the section you want.

Painful periods

Heavy periods

Irregular periods

No periods (absent periods)

PMS (premenstrual syndrome)

Endometriosis  

Painful periods

Pain during periods is common. It's caused by the womb contracting to push out the blood.

Exercise may help to relieve the pain, and some women find over-the-counter painkillers, such as  paracetamol or ibuprofen , effective. Your pharmacist can advise on suitable ones.

If the pain is so severe that it affects your daily life, talk to your doctor. Hormonal contraception, such as the combined pill, intrauterine system - IUSpatch or injection, can reduce period pain.

Find out more about  painful periods.

Heavy periods

Some women naturally have heavier periods than others, but if your periods are so heavy that they impact on your life, there is help available.

Talk to your GP about your bleeding, including how often you have to change your sanitary protection (towels, tampons or menstrual cup).   

Your doctor can investigate why you're having heavy bleeding. These investigations may include blood tests and scans.

The National Institute for Health and Clinical Excellence (NICE) advises that there are a number of possible treatments available on the NHS for women who have heavy periods. These include: 

  • some forms of hormonal contraception, such as the IUS (Mirena), implant, injection or combined pill
  • tranexamic acid
  • non-steroidal anti-inflammatory drugs (NSAIDs)
  • oral progestogen (a synthetic version of the hormone progesterone released naturally in your body)

For more information on these treatments, see the NICE advice on treatment for women with heavy menstrual bleeding.

In some cases, surgery may be an option if other treatments don't work, or if there are problems with the womb, such as  fibroids (non-cancerous growths). Surgery may include removing fibroids, the lining of the womb, or the womb itself.

Find out more about  heavy periods, including treatment.

Use this tool to check if your periods are heavy.

Irregular periods

A period normally lasts from two to seven days, with the average period being five days long.

However, some women have an irregular menstrual cycle. This is where there is a wide variation in:

  • the time between your periods (they may arrive early or late)
  • the amount of blood you lose (periods may be heavy or light)
  • the number of days that the period lasts

Irregular periods can be common during puberty and just before the menopause.

You can find out more about the causes of irregular periods, which can include a hormone imbalance and changing your method of contraception, and treating irregular periods.

Absent periods

Having no periods may indicate an underlying health problem, so see your GP. Periods can also stop as a result of severe weight loss, stress or strenuous exercise.

Find out more about absent periods.

Premenstrual syndrome (PMS)

PMS is thought to be linked to changing levels of hormones throughout the menstrual cycle. Not all women experience PMS, and among those who do, the range and severity of symptoms can vary.

Severe PMS can disrupt a woman's personal and work life, making it hard to function in the days before her period.

Symptoms include: 

  • mood swings
  • irritability
  • depression
  • headaches
  • bloating
  • breast tenderness

Symptoms appear and can intensify during the second half of the menstrual cycle, and then ease and disappear after the period has started.

The Royal College of Obstetricians and Gynaecologists has useful information on managing PMS.

Some women who have PMS can find they benefit from following general health advice, such as eating a healthy balanced diet, reducing alcohol and caffeine intake, and getting regular exercise to keep fit. Cognitive behavioural therapy may help too. This is when a counsellor helps you to recognise negative behaviours and work out strategies to change them. Find out more about counselling.

Various complementary therapies and vitamin supplements claim to help with PMS. While more research is needed, current information seems to show that magnesium and Agnus Castus can help some women.

Some complementary therapies can interact with medication, so get advice from your doctor before starting any.

Other treatments include: 

Sometimes there's an underlying psychological condition that doesn't go away when the period finishes. This is an indication that it's not a symptom of PMS. In such cases, treatment for the psychological condition may help. 

Find out more about  PMS, including symptoms and treatment.

Endometriosis

This is a condition in which the cells lining the womb (endometrium) appear in other areas of the body. This is usually in the abdominal area, including the pelvis, ovaries and fallopian tubes.

Period hormones cause the ovaries to release an egg, and the womb lining to thicken. If the egg isn't fertilised, the womb lining breaks down and bleeds, and leaves the body as a period. Endometriosis cells elsewhere in the body also break down and bleed, which causes inflammation, pain and adhesions (scar tissue).

Not all women have symptoms, but common symptoms can include: 

  • painful, heavy or irregular periods
  • pain during or after sex
  • infertility
  • problems opening your bowels (passing stools)

These symptoms can signify a range of other conditions. A laparoscopy (a surgical procedure in which the surgeon looks into the abdomen with a small camera) is the only way to make a definite diagnosis.

Different treatment options include:

  • painkillers
  • hormone treatments, such as progestogen
  • hormonal contraceptive methods, such as the combined pill, patch or IUS
  • drugs that can cause a temporary and reversible menopause by stopping the body producing oestrogen

In severe cases, surgery can be carried out to remove the endometriosis or the ovaries and womb.
 
Some, but not all, women with endometriosis have difficulty getting pregnant. 

Find out more about  endometriosis

If you have missed a period and think you might be pregnant, find out about the signs and symptoms of pregnancy and doing a pregnancy test.

Medical Review: September 27, 2012

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