Period problems
Periods that are heavy, painful, irregular or missing
Period problems include periods that are heavy, painful, irregular or missing. They are common, but you do not have to live with them. Most have a clear cause, such as fibroids, PMOS (once called PCOS) or a change in hormones. Dr Leng Meng Chik at KPJ Seremban Specialist Hospital finds the cause and explains your treatment choices.
Good to know
A period diary helps a lot. Write down the days you bleed, how heavy it is and how much pain you feel. Bring it to your visit, or use a period app.
See a doctor soon if you have
- Bleeding between periods or after sex
- Any bleeding after menopause
- Very heavy bleeding with dizziness or fainting
- A missed period with strong pain on one side of your tummy
If you have any of these, please see a doctor soon. For sudden, severe pain or heavy bleeding, go to the nearest emergency department.
When is a period too heavy?
Doctors look at how bleeding affects your life, not only how much you lose. These are common signs:
- You change a pad or tampon every 1 to 2 hours
- You bleed through to your clothes or bedsheets
- You pass clots bigger than about 2.5 cm
- Your period lasts more than 7 days
- You need to use two kinds of protection at once
When is period pain not normal?
Some cramping is normal. Pain is a warning sign when:
- Painkillers do not help
- It stops you from going to work or school
- You also have pain between periods or during sex
- It has got worse over the years
Why are my periods irregular?
Periods can change for many reasons. Common causes are PMOS, thyroid problems, stress, weight change, breastfeeding and the years before menopause. If your period is late, do a pregnancy test first.
How does Dr Leng find the cause?
She asks about your periods and your health. She may examine you and do an ultrasound scan. Blood tests can check for anaemia, thyroid problems and hormone levels. If your Pap smear is due, she can do it at the same visit.
What are the treatment choices?
Treatment depends on the cause and on what matters to you, such as whether you plan a pregnancy.
- Painkillers, taken as soon as pain starts
- Tranexamic acid, a non-hormone medicine that makes bleeding lighter
- Hormone choices, such as the pill or a hormone coil (IUS)
- Treating the cause, such as fibroids or PMOS
What else do women ask about period problems?
Is it normal to have no period?
Not usually. It can be normal if you are pregnant, breastfeeding, using some kinds of contraception or past menopause. Otherwise, if you miss three periods in a row, see a doctor.
Can heavy periods make me tired?
Yes. Heavy bleeding can cause anaemia, which means low iron in your blood. You may feel tired, weak or short of breath. A simple blood test can check this.
Which painkillers help period pain?
Medicines like ibuprofen or mefenamic acid work well for many women. They work better when you take them as soon as the pain starts. Ask your doctor or pharmacist if they are safe for you.
Do I need surgery for period problems?
Most women do not. Medicines work for many causes. Surgery is only one choice, and mainly for certain cases of fibroids or other problems found on a scan.
Dr Leng Meng ChikConsultant Obstetrician & Gynaecologist, MD (UNIMAS), MRCOG (UK). MMC 54266. KPJ Seremban Specialist Hospital. About Dr Leng
Sources
Related conditions
See Dr Leng about period problems in Seremban.
Bring your questions. Dr Leng will explain what is going on and help you choose what to do next.