Normal Menstruation

• Menstruation typically begins when a girl is about 12 - 13 years old.
• The normal length of a menstrual cycle is 21 - 35 days, the average cycle being 28 days.
• Menstrual periods typically last 4 - 8 days, the average period lasting 6 days.
• Menopause usually occurs around the age of 51. Many women begin to experience symptoms when they are 40 - 44 years old.

Menstrual Disorders

Menstrual disorders include:

• Painful cramps (dysmenorrhea) during menstruation. Primary dysmenorrhea is directly related to and caused by menstruation. Secondary dysmenorrhea is caused by another condition, such as endometriosis or uterine fibroids.
• Heavy bleeding (menorrhagia, metrorrhagia, or menometrorrhagia) includes prolonged menstrual periods or excessive bleeding.
• Absence of menstruation (amenorrhea) can be either primary or secondary. Primary amenorrhea is considered when a girl does not begin to menstruate by the age of 16. Secondary amenorrhea occurs when periods that were previously regular become absent for at least three cycles.
• Light or infrequent menstruation (oligomenorrhea) refers to menstrual periods that occur more than 35 days apart. It usually is not a cause for concern, except if periods occur more than 3 months apart.

Medications for Menstrual Disorders

• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, or acetaminophen can help provide pain relief for cramps.
• Oral contraceptives can help regulate menstrual periods and reduce heavy bleeding. Newer continuous-dosing oral contraceptives reduce or eliminate menstrual periods.
• Gonadotropin-releasing hormone (GnRH) agonists are sometimes used to treat severe heavy bleeding.
• The androgen danazol suppresses estrogen and is sometimes used in combination with an oral contraceptive to help prevent heavy bleeding.