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The onset of menstruation is referred to as menarche, and most girls will get their first period between the ages of 12 and 13. Some, however, will start their periods when they are as young as eight, while others won't menstruate until they are 16. Women have an average of 500 (!!!) periods during their lifetime. After that, the menopause sets in and a woman can no longer get pregnant.

Women have painful, prolonged or irregular periods for a variety of reasons. Some require medical attention for health reasons, while others should be looked at by a doctor because they cause the woman discomfort or even excrutiating pain. 

Prolonged And Abnormally Heavy Periods: Causes

Menorrhagia is the medical term for prolonged or abnormally heavy periods. You will qualify for this diagnosis if your period lasts longer than seven days or your blood and tissue loss is heavy enough to force you to change tampons or pads every hour for multiple hours. Women with menorrhagia may pass large clots during their periods and may find that they need to get up to change their pads or tampons even during the night. Some women lose so much blood they feel weak and fatigued during their periods. 

Menorrhagia can be caused by a hormonal imbalance (including one caused by ovarian dysfunction), uterine fibroids and polyps, using an IUD (intrauterine device), cancer, certain medications, and a number of medical conditions including blood disorders, pelvic inflammatory disease, and adenomyosis. The latter is a condition similar to endometriosis, in which uterine lining invades the muscular layer of the uterus. 

It's important to see your doctor for proper diagnosis if your periods are making your life hell. Treatment options are available and quite likely to be very effective, depending on the cause of your menorrhagia. They include iron supplements to keep your blood iron levels up, hormonal contraceptives, prescription pain relief, and even endometrial ablasion to clean your uterus of endometrial tissue. If your heavy and prolonged periods were caused by an undelying condition, that condition will obviously have to be treated. In extreme cases, a hysterectomy (the surgical removal of the uterus) is the best solution. Don't go there yet though, as it's quite possible your treatment will be much, much less invasive. 

What Are Irregular Periods?

Irregular menstrual cycles are cycles that last shorter than 21 days, longer than 35 days, or are just plain unpredictable. The good news is that irregular cycles are frequently caused by your age: young girls who recently started menstruating and women approaching the menopause are irregular for completely normal reasons, and they do not need to worry. Women who recently had a baby can expect to have no cycles or irregular cycles for quite a while. Those who are breastfeeding may even be period-free for years, if they nurse for a long time.

Irregular cycles can also be caused by excessive exercise (think pro-athletes or people working out as much as pro-athletes), weight loss or weight gain, and stress. In these cases, periods are likely to become regular again with advised lifestyle adaptions. 

Other causes of irregular menstrual cycles include Polycystic Ovary Syndrome (which can be managed with medication and weight loss), certain contraceptives (oral, IUDs, Depo Provera), and thyroid disorders (which can also be managed with medications).

When you become aware that you have simply stopped menstruating, you should always suspect pregnancy if you are sexually active. Yes, even if you are perimenopausal. 

The bottom line is clear: if your periods are troubling you and you are not aware of the cause or are in unmanagable pain, it's without doubt time to see your OBGYN or family doctor.

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