Your period

When do periods start?

In Australia, the average age to have your first period is 12 to 13, but it can start as early as nine and as late as 16. See your doctor if your periods have not started by the age of 16 to 17. There are many causes of irregular or absent periods.

Your final period is called 'menopause'. In Australia, the average age to reach menopause is 51 to 52, but it can happen as late as 60.

Your period may change at different life stages. For example, it may not be regular in the lead-up to menopause (perimenopause).

What to expect during your period

Your period might last from three to seven days. Most people lose less than 80 mL of blood in total during their period.

Bleeding can vary from a small amount to a heavy loss. Your period flow may be heavier for the first three days and lighter towards the end.

The colour of your period can change from dark brown to bright red.

Small blood clots are normal, but if you notice lots of clots or clots larger than a 50-cent coin, talk to your doctor.

You might experience ovulation pain in the middle of your cycle. You may also experience light bleeding (spotting) between periods. Spotting is when you notice a small amount of blood on your underwear or toilet paper, but it’s not enough to need a period product.

If pain or bleeding around the time of ovulation often lasts longer than three days, see your doctor.

Your period may have a distinct smell, but this is normal, so you don’t need to use douches or perfumed products, which can cause vulval irritation.

Period symptoms

Some people experience physical and emotional symptoms when they get their period. For example, cramping, bloating, tender breasts and mood changes.

It’s important to rest and take time for yourself, especially if your energy or mood is low. If period-related symptoms are causing you to miss school, work and other daily activities, see your doctor.

Symptoms can affect you at any age, but they are more common in teenage years and in the lead-up to menopause.

Symptoms experienced before your period are called ‘premenstrual syndrome’ or PMS.

Conditions related to your period

Some medical conditions are associated with periods, so it’s important to see your doctor if your periods start to impact your quality of life. Your doctor will ask about your medical history and may do an examination to help rule these conditions in or out.

Endometriosis

Endometriosis is a condition where cells similar to those that line the uterus are found in other parts of the body, mainly in the pelvis and reproductive organs. This condition can cause mild to severe pain and may affect your fertility.

Adenomyosis

Adenomyosis is when cells similar to the lining on the inside of your uterus are also in the muscle wall of your uterus. This can cause painful and heavy periods, and persistent pelvic pain.

Polycystic ovary syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is a hormonal condition that affects about one in 10 women. It can cause a range of symptoms, including irregular periods.

Premenstrual dysphoric disorder (PMDD)

Premenstrual dysphoric disorder (PMDD) is a condition that causes severe emotional and psychological distress in the lead-up to your period. It’s not the same as PMS.

Ovulation pain

Some people experience pain in their belly (abdomen) when their ovary releases an egg. This pain usually settles after a day. It can sometimes be worse if you have certain conditions, such as endometriosis.

What can affect your period?

Your period can be affected by many things, including your physical and emotional health and lifestyle.

Medicines and medical treatments

Medicines and medical treatments can affect your period. For example:

• copper intrauterine devices (IUDs) can cause heavier bleeding, longer periods and more painful periods
• blood-thinning medicines can cause abnormally heavy periods
• some medicines, such as antipsychotics, can cause irregular periods
• medicines such as anti-inflammatory drugs, tranexamic acid and mefenamic acid (Ponstan®) can make periods lighter
• some cancer treatments can cause irregular or absent periods.

Some people with ADHD say their ADHD medicine doesn’t work as well when they have their period, but more research is needed in this area.

Illness

If you have a cold, flu or other illness, your period may come late, or you may skip a period.

Hormones

Changing hormones, hormone conditions and hormone treatments can affect your period. For example:

• changes in hormone levels at different life stages, such as after childbirth and the lead-up to menopause (perimenopause), can cause changes in your periods
• thyroid problems can make your periods very light, heavy or irregular, or cause your periods to stop for several months
• hormonal contraception (e.g. the Pill) can help regulate periods and reduce bleeding
• gender-affirming hormone therapy may suppress or stop periods.

Other factors

Other factors can affect your period. For example:

• high levels of stress or anxiety can contribute to PMS symptoms and irregular periods
• regular physical activity can help reduce PMS symptoms and period pain
• too much exercise can lead to absent periods (amenorrhoea)
• eating disorders, especially anorexia nervosa, can cause periods to stop
• having a higher waist circumference is associated with irregular cycles, absent periods, heavy bleeding and higher rates of PMS and PMDD.

Sex during your period

You can have sex during your period, but it’s important to practise safer sex to stop the spread of sexually transmitted infections (STIs).

You should also use contraception if you don’t want to get pregnant.

When to see your doctor

There are many reasons you might need to see your doctor about your period. For example, if:

• your period patterns change
• you have increasingly heavier periods
• you have long periods (more than eight days)
• your periods come less than three weeks apart
• your periods come more than two to three months apart.

Also see your doctor if:

• you bleed between periods
• you bleed after menopause
• you bleed after having sex
• you have painful periods that affect your quality of life.