In the U.S. the average age of a woman's first period is 12.3 years old, which means most women have menstrual cycles a significant portion of their lives. Because of this, some of the most common questions asked are about periods and what is considered "normal."
Listen as Dr. Sara Ackerman, obstetrician/gynecologist with Allina health, discusses the most common menstrual cycle questions many women have.
Selected Podcast
What is a "Normal" Menstrual Cycle?
Featured Speaker:
Learn more about Sara Ackermann, DO
Sara Ackermann, DO
Sara Ackermann, DO is a board-certified obstetrician and gynecologist with professional interests in abnormal bleeding, contraception and menopause.Learn more about Sara Ackermann, DO
Transcription:
What is a "Normal" Menstrual Cycle?
Melanie Cole (Host): In the United States, the average age of a woman’s first period is about 12 years-old, which means most women have menstrual cycles a significant portion of their lives. My guest today is Dr. Sara Ackerman. She’s an obstetrician/gynecologist with Allina Health. Welcome to the show, Dr. Ackerman. What are the characteristics of a normal period? When a young girl gets her first period, does it look like a 25-year-old girl’s period, or do they look a little bit different?
Dr. Sara Ackerman (Guest): When a female gets her first period, in the beginning, it tends to be a little bit lighter, and maybe a little bit more irregular. It can take maybe a year or so for things to get into that regular 28- to 30-day cycle.
Melanie: So if you see a little bit of spotting – if a young girl, 12, 13, 14 years-old – does that mean that they’ve now started their menstrual cycle?
Dr. Ackerman: It can. A first period often can just be a little bit of light spotting as you mentioned.
Melanie: What should women look out for in their teen years and into their twenties? What do your patients ask you most about, and what’s normal with a period?
Dr. Ackerman: Well, first of all, a normal period tends to be about 2 to 7 days, and then the cycle is usually about 28 days. Typically blood flow is heavier in the beginning, or the first two days of the menstrual cycle, and then tends to lighten up a little bit before the period is over. Things that we would want to look out for would be if you were changing your tampon or pad pretty often, though bleeding that is requiring a change every hour or two might be considered a little bit too heavy.
Melanie: And if that’s the case, is there anything that can be done about that?
Dr. Ackerman: Well, I would definitely come in and talk to your provider. There are things that we would want to do some evaluation for, fibroids, or wanting to know if you were having a lot more pain or cramping with periods, and then certainly things like contraceptive medications can help lighten and regulate bleeding.
Melanie: So sometimes in a girl’s period they see what looks like a big clot, or a big clump of blood. Is that normal?
Dr. Ackerman: I would say that some clotting can happen, especially in the beginning of the menstrual cycle, but you shouldn’t be passing blood clots that are larger than a quarter consistently.
Melanie: What about your overall health, Dr. Ackerman? How much does that affect, or impact your monthly cycle?
Dr. Ackerman: Yeah, I think – definitely being healthy and active, exercising, and being in a normal weight category can help make periods regular and lighter. Women who tend to be a little overweight, sometimes have irregular menstrual cycles where they don’t have bleeding for a while and then when they do get a period, it can be really, really heavy. Conversely, if you’re underweight, or very malnourished, you may not be experiencing regular menstrual cycles either.
Melanie: And how much of a role does genetics play in when you start your first menstrual period and when maybe you start menopause?
Dr. Ackerman: You can talk to your female relatives, especially your mother about when she began menstruation and when she ended. As you mentioned, the typical age to begin a period is about 12-years-old and then interestingly, if you’re on the shorter side, you might end up getting your period closer to that age 12. Taller girls tend to get their period a little bit later, and that’s sort of to do with growth and development and the effects of estrogen in terms of final height, and that can have a genetic component. And then we know that women often experience menopause or the cessation of periods around the same time as their mother. That average age to end periods is around 51 in the United States, but if your mother ended her periods earlier, you might expect, or anticipate that you will also end your periods a little bit earlier.
Melanie: Now, periods have side effects, Dr. Ackerman, sometimes cramps, sometimes a little bit of headaches, there’s a lot of things that could go on. What do you tell your patients about dealing with some of those side-effects?
Dr. Ackerman: I like to have patients track their menstrual cycles, especially if they’re not on a contraceptive method that allows them to predict when a period is going to happen. I think it helps to know before hand when the period is going to occur so you can do things like start taking an NSAID, so something like Aleve or Ibuprofen, maybe the day before your menstrual cycle is going to start. I think that can be very helpful for reducing blood flow and also helping to eliminate cramping that can occur with your menstrual cycle.
Melanie: What about stress? What role, if any, does it play in our menstrual cycle? Can it make it heavier, can it make it lighter, can it change the regularity of it? What about stress?
Dr. Ackerman: I think stress definitely plays a role in how our bodies function and a lot of times what we’ll notice is that irregularity in cycling. Many women notice that they have a very predictable period, that it’s every 28-days as the normal, but when you’re under a lot of stress, not eating well, not exercising, and not taking good care of yourself, sometimes that can get disrupted.
Melanie: And are there some things you’d like to tell women – you mentioned heavy bleeding before – but are there some things you’d like to mention to them that would signal a trip to their doctor, something that isn’t quite normal – if their bleeding patterns have changed, or the color has changed – are any of those things that we should be watching out for?
Dr. Ackerman: I think if there is a change in the menstruation – in the flow, in the regularity, in timing, and especially in the severity of cramping, then it is a good reason to come in and talk to your ob/gyn.
Melanie: Would any of those things signal things such as endometriosis -- and you mentioned fibroids before – do we worry about those when those changes might occur?
Dr. Ackerman: Absolutely. Heavy bleeding can be a signal of something going on with the uterus itself, and that does include fibroids as the most common thing that can lead towards heavy bleeding. Definitely, if cramping is very severe, that can be a signal of endometriosis.
Melanie: Now, I know some young girls, and even their mothers, think about birth control not as necessarily – the pill – not as necessarily something only to prevent pregnancy, but also to regulate periods. Speak to that just a minute.
Dr. Ackerman: I think that’s an extra added benefit of using birth control methods. Many of them regulate the cycle, cause the bleeding to be a lot lighter. It’s very normal on a birth control pill to have maybe a 2- or a 3-day very, very light menstrual cycle and I think that’s very beneficial for women. If you’re busy and have an active lifestyle, it’s nice to not have a really prolonged period and have it be shorter.
Melanie: And now a question that I’m sure you get often – as a mother with a teenager that’s getting her first period, do you recommend using tampons right away? Should they be using pads? What do you recommend for controlling those periods, especially in the teenage years?
Dr. Ackerman: I think that for teenagers, it takes a lot of patience and teaching and familiarity with using tampons. There’s no reason that an adolescent female who is just starting menstruation shouldn’t use a tampon, but had mentioned before that a lot of times adolescence have very light bleeding and irregular bleeding and so they might feel more comfortable with using a pad, to begin with.
Melanie: So wrap it up for us, with your best advice -- what women, what young girls and their mothers ask you every day about normal menstrual cycles -- and give us your best advice about how to deal with that, discussing it with your daughter and how – really what you want people to know.
Dr. Ackerman: I think it is a good idea to always have a conversation with your provider about expectations of what is going to happen when the period begins and certainly just to know that there are definitely things that we can offer and do that can help regulate the menstrual cycle and also makes the cramping and the other side-effects a little more tolerable.
Melanie: Thank you, so much, Dr. Ackerman, for being with us today. That’s such great information for women and young girls to hear. You’re listening to The Well Cast with Allina Health, and for more information, you can go to AllinaHealth.org, that’s AllinaHealth.org. This is Melanie Cole. Thanks, so much, for listening.
What is a "Normal" Menstrual Cycle?
Melanie Cole (Host): In the United States, the average age of a woman’s first period is about 12 years-old, which means most women have menstrual cycles a significant portion of their lives. My guest today is Dr. Sara Ackerman. She’s an obstetrician/gynecologist with Allina Health. Welcome to the show, Dr. Ackerman. What are the characteristics of a normal period? When a young girl gets her first period, does it look like a 25-year-old girl’s period, or do they look a little bit different?
Dr. Sara Ackerman (Guest): When a female gets her first period, in the beginning, it tends to be a little bit lighter, and maybe a little bit more irregular. It can take maybe a year or so for things to get into that regular 28- to 30-day cycle.
Melanie: So if you see a little bit of spotting – if a young girl, 12, 13, 14 years-old – does that mean that they’ve now started their menstrual cycle?
Dr. Ackerman: It can. A first period often can just be a little bit of light spotting as you mentioned.
Melanie: What should women look out for in their teen years and into their twenties? What do your patients ask you most about, and what’s normal with a period?
Dr. Ackerman: Well, first of all, a normal period tends to be about 2 to 7 days, and then the cycle is usually about 28 days. Typically blood flow is heavier in the beginning, or the first two days of the menstrual cycle, and then tends to lighten up a little bit before the period is over. Things that we would want to look out for would be if you were changing your tampon or pad pretty often, though bleeding that is requiring a change every hour or two might be considered a little bit too heavy.
Melanie: And if that’s the case, is there anything that can be done about that?
Dr. Ackerman: Well, I would definitely come in and talk to your provider. There are things that we would want to do some evaluation for, fibroids, or wanting to know if you were having a lot more pain or cramping with periods, and then certainly things like contraceptive medications can help lighten and regulate bleeding.
Melanie: So sometimes in a girl’s period they see what looks like a big clot, or a big clump of blood. Is that normal?
Dr. Ackerman: I would say that some clotting can happen, especially in the beginning of the menstrual cycle, but you shouldn’t be passing blood clots that are larger than a quarter consistently.
Melanie: What about your overall health, Dr. Ackerman? How much does that affect, or impact your monthly cycle?
Dr. Ackerman: Yeah, I think – definitely being healthy and active, exercising, and being in a normal weight category can help make periods regular and lighter. Women who tend to be a little overweight, sometimes have irregular menstrual cycles where they don’t have bleeding for a while and then when they do get a period, it can be really, really heavy. Conversely, if you’re underweight, or very malnourished, you may not be experiencing regular menstrual cycles either.
Melanie: And how much of a role does genetics play in when you start your first menstrual period and when maybe you start menopause?
Dr. Ackerman: You can talk to your female relatives, especially your mother about when she began menstruation and when she ended. As you mentioned, the typical age to begin a period is about 12-years-old and then interestingly, if you’re on the shorter side, you might end up getting your period closer to that age 12. Taller girls tend to get their period a little bit later, and that’s sort of to do with growth and development and the effects of estrogen in terms of final height, and that can have a genetic component. And then we know that women often experience menopause or the cessation of periods around the same time as their mother. That average age to end periods is around 51 in the United States, but if your mother ended her periods earlier, you might expect, or anticipate that you will also end your periods a little bit earlier.
Melanie: Now, periods have side effects, Dr. Ackerman, sometimes cramps, sometimes a little bit of headaches, there’s a lot of things that could go on. What do you tell your patients about dealing with some of those side-effects?
Dr. Ackerman: I like to have patients track their menstrual cycles, especially if they’re not on a contraceptive method that allows them to predict when a period is going to happen. I think it helps to know before hand when the period is going to occur so you can do things like start taking an NSAID, so something like Aleve or Ibuprofen, maybe the day before your menstrual cycle is going to start. I think that can be very helpful for reducing blood flow and also helping to eliminate cramping that can occur with your menstrual cycle.
Melanie: What about stress? What role, if any, does it play in our menstrual cycle? Can it make it heavier, can it make it lighter, can it change the regularity of it? What about stress?
Dr. Ackerman: I think stress definitely plays a role in how our bodies function and a lot of times what we’ll notice is that irregularity in cycling. Many women notice that they have a very predictable period, that it’s every 28-days as the normal, but when you’re under a lot of stress, not eating well, not exercising, and not taking good care of yourself, sometimes that can get disrupted.
Melanie: And are there some things you’d like to tell women – you mentioned heavy bleeding before – but are there some things you’d like to mention to them that would signal a trip to their doctor, something that isn’t quite normal – if their bleeding patterns have changed, or the color has changed – are any of those things that we should be watching out for?
Dr. Ackerman: I think if there is a change in the menstruation – in the flow, in the regularity, in timing, and especially in the severity of cramping, then it is a good reason to come in and talk to your ob/gyn.
Melanie: Would any of those things signal things such as endometriosis -- and you mentioned fibroids before – do we worry about those when those changes might occur?
Dr. Ackerman: Absolutely. Heavy bleeding can be a signal of something going on with the uterus itself, and that does include fibroids as the most common thing that can lead towards heavy bleeding. Definitely, if cramping is very severe, that can be a signal of endometriosis.
Melanie: Now, I know some young girls, and even their mothers, think about birth control not as necessarily – the pill – not as necessarily something only to prevent pregnancy, but also to regulate periods. Speak to that just a minute.
Dr. Ackerman: I think that’s an extra added benefit of using birth control methods. Many of them regulate the cycle, cause the bleeding to be a lot lighter. It’s very normal on a birth control pill to have maybe a 2- or a 3-day very, very light menstrual cycle and I think that’s very beneficial for women. If you’re busy and have an active lifestyle, it’s nice to not have a really prolonged period and have it be shorter.
Melanie: And now a question that I’m sure you get often – as a mother with a teenager that’s getting her first period, do you recommend using tampons right away? Should they be using pads? What do you recommend for controlling those periods, especially in the teenage years?
Dr. Ackerman: I think that for teenagers, it takes a lot of patience and teaching and familiarity with using tampons. There’s no reason that an adolescent female who is just starting menstruation shouldn’t use a tampon, but had mentioned before that a lot of times adolescence have very light bleeding and irregular bleeding and so they might feel more comfortable with using a pad, to begin with.
Melanie: So wrap it up for us, with your best advice -- what women, what young girls and their mothers ask you every day about normal menstrual cycles -- and give us your best advice about how to deal with that, discussing it with your daughter and how – really what you want people to know.
Dr. Ackerman: I think it is a good idea to always have a conversation with your provider about expectations of what is going to happen when the period begins and certainly just to know that there are definitely things that we can offer and do that can help regulate the menstrual cycle and also makes the cramping and the other side-effects a little more tolerable.
Melanie: Thank you, so much, Dr. Ackerman, for being with us today. That’s such great information for women and young girls to hear. You’re listening to The Well Cast with Allina Health, and for more information, you can go to AllinaHealth.org, that’s AllinaHealth.org. This is Melanie Cole. Thanks, so much, for listening.