Periods: do I need a doctor?

Dr Laura Cassidy, an obstetrician and gynaecologist, explains what’s normal and what’s not for your monthly period.

Periods last around three to seven days. The average menstrual cycle lasts 28 days, although it’s normal to have a cycle that's shorter or longer than this.

Women's periods can change. This doesn’t necessarily mean there's a serious problem, but it does need to be checked.

"To get help, women should go where they feel most comfortable," says Dr Cassidy. "This could be a well woman clinic, a general practice or a community contraceptive clinic."

Missed periods

Missing a period could mean that you’re pregnant. If you miss a period and you've had sex, take a pregnancy test to find out.

“If you’re not pregnant and you miss two or three periods, seek medical advice,” says Dr Cassidy. For many women, missed periods are due to upset hormones, and you may need help.

There can be other reasons for missed periods in some women, including:

  • stress
  • sudden weight loss
  • intense athletic activity
  • taking the contraceptive pill

“If you’ve been on the contraceptive pill for a long time, you might miss a period every now and again. It's not particularly significant,” says Dr Cassidy. Some types of contraception, such as the contraceptive injection and the IUS (intrauterine system) called Mirena, can stop periods altogether.

It’s not unusual for women approaching the menopause to miss periods, as ovulation becomes less regular. The average age for the menopause is 50 to 55, but it's possible for some women to have an early menopause in their teens, 20s or 30s (see Early menopause: real story).

Read more about the menopause.

Women whose periods stop before they're 45, or who are still bleeding when they're over 55 years old, should get medical help.

Bleeding between periods or after sex

If you bleed between periods or after sex, get this checked out by a professional as it can be a sign of infection, an abnormal cervix or, in rare cases, cancer.

“If you bleed between periods or after sex, there might be some abnormality of the cervix,” says Dr Cassidy.

The abnormalities can be harmless – for example, polyps – or they can be due to an infection such as chlamydia.

Find out what causes bleeding between periods.

If you're worried, your community contraceptive clinic, sexual health clinic or genitourinary (GUM) clinic can offer advice, testing and treatment. Find your local sexual health clinic.

Sometimes, taking a low-dose contraceptive pill can cause bleeding between periods. This can be corrected by changing pills. Find out about different methods of contraception.

The National Cervical Screening Programme is a scheme that aims to detect abnormalities in the cervix that could lead to cancer, if untreated. Women aged 25 to 49 are offered screening every three years. Women aged 50 to 64 are offered it every five years.

Sudden period changes

If your periods suddenly change – for example, they become heavier or longer – seek advice from a healthcare professional. This is especially important for women over 40.

"For most women under 40 with slightly irregular cycles, these symptoms do not have a serious cause," says Dr Cassidy. 

"But if periods become much heavier in women over 40, or if they are lasting longer or having erratic bleeding, this needs to be investigated."

Changes in women over 40 can be associated with endometrial cancer, cervical or endometrial polyps, or a pre-cancerous condition (hyperplasia), which can be treated if caught early.

Bleeding after the menopause

If you have any bleeding after menopause, seek medical attention urgently. "After a woman has had a year with no periods, she should not bleed," says Dr Cassidy. "If you do, seek advice right away. Don't wait to see if it happens again."

Read one woman's experience of bleeding after the menopause.

Some women taking HRT to control the symptoms of menopause will have bleeding or spotting. This depends on the type of HRT you are taking. If you take the cyclical, or sequential, preparation, then you’ll have a regular period-type bleed, known as a withdrawal bleed. See a doctor if you notice any bleeding between these withdrawal bleeds, whether it happens after sex or at any other time.

If you take the continuous combined preparation, you won’t have a regular bleed, but you may notice spotting. Dr Peter Bowen-Simpkins, consultant gynaecologist and medical expert for the charity Wellbeing of Women, says: "Women taking continuous combined HRT are period-free, but up to 50% of women may have slight spotting in the first year of taking it. If this spotting is persistent or heavier than just spotting, it should be reported to your doctor immediately."

If you switch from cyclical to continuous combined HRT, and you notice bleeding, you should stop. "In these circumstances, you will need to return to the sequential preparation and report any untoward bleeding, should it occur," says Dr Bowen-Simpkins.

Find out about self-help methods to help you cope with the menopause.

Discharge during your period

It’s normal to have vaginal discharge (secretions), and it’s normal for the discharge to change during the menstrual cycle.

“A clear or creamy white discharge is normal, and often makes slightly yellowish stains on underwear,” says Dr Cassidy. Around ovulation, the discharge becomes stretchy, a bit like raw egg white.

See a doctor if you have discharge that's green, blood-stained or smells, as this could be a sign of infection. 

Read more articles about periods.

Menstrual cycle: animation

This animation explains in detail how the menstrual cycle works.

Media last reviewed: 21/02/2013

Next review due: 21/02/2015

Page last reviewed: 02/08/2014

Next review due: 02/08/2016

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The 27 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Lauracooper010 said on 02 August 2014

Hi! my periods normally last 5 days, last month it only lasted 3 days. This month it only lasted 2 days. What does this mean? Should I be worrie?

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Xandra_123 said on 28 July 2014

Hi everyone, I am 18 years old and I am having serious problems with my menstrual cycle! For nearly a year now (roughly) I have not had a regular menstrual cycle and I have either had an ongoing light period with patches of heavy flow here and there or no period at all for weeks to months on end. This really worries me and as stupid as it sounds I have not gone to see a doctor in the fear I will be told some really bad news. Around 2 years ago I was on the contraceptive pill Cerrazette but I decided to suddenly stop using it due to its side effects. Also in the past few years I have put on alot of weight and have gained around 5 stone, and seeing as I was heavy before this has put my total weight to around 18 stone. Could it be my extreme weight which is causing these abnormalities to my menstrual cycle? Please help!!!

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fat786 said on 24 July 2014

hi i am 25 year and i have a period problem period stop for a day or two and is heavy period i get very dezy i don't feel good plz help me....

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Kura329 said on 21 June 2014

To RebeccaC28: Might want to get a second opinion from another doctor. If your period has changed suddenly (in this case increased duration) it could be signs of hormonal changes, stress, etc. If you are on the pill and changed from one to another (upped your dosage / lower your dosage, or gone from a monophase pill to a triphase pill) it can cause changes in flow. Or if you changed from the pill to the patch, or the shot, that can also change your hormone balances.

To days123: I would definitely go to you OB/GYN about heavy periods, and constant heavy periods that have not changed since you started having your period. It could be a sign of endometriosis, or the thickening of the endometrium of your uterus. This is even more likely if you have terrible cramps associated with your heavy periods.

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days123 said on 04 June 2014

Hi,

I am just starting to coming out of the adolescent age and I have always suffered with heavy periods.

For the past 5-6 months my periods have become even heavier and im now experencing flooding and passing even larger clots.

Should I go to see my GP about this?

Any advice will be appreicated,
Thanks!

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RebeccaC28 said on 29 April 2014

Hi,

I am 23. I have been on my period so far for 42 days and it doesn't seem to show any signs of slowing down. It is really heavy that I have to wear 2 night time pads.

I have been to the doctor and he told me my bloods were clear so there is no abnormality.

I was just wondering (as this has never happened to me before, my periods used to run like clockwork, for between 7 - 10 days) has this happened to anyone else? And could I be pregnant?

Would appreciate any help!

Thanks!

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shazab said on 29 January 2014

I am 42 years old and I am over a week late with my period. I have taken pregnancy tests on 2 different occasions and both are negative. The last 2 periods I had I came on a week early both times and I'm normally like clockwork, should I see a doctor

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badgirl420 said on 02 December 2013

I'm a 34 year old female. My menstrual cycle is two weeks fairly. I'm experiencing a heavy flow, with bright red blood. With extremely bad cramps. I have never had this happen to me before. Should I be worried? I have recently gone through a lot of stress & my eating habits have changed. Should I see my gynicoligest?

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Advice needed said on 26 November 2013

Me and my girlfriend have had oral sex and now she has missed her period, she has the signs and symptoms of her normal period but we are worried what could have happened?

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Funkyfi said on 14 August 2013

I have been on the pill for about 10 years, i recently stopped it about March 2013 thereafter i had 2 periods in April & May 2013.
Since May i have not had a period , almost 3 months now.
I Have taken 2 Pregnancy tests both were negative. I am not sure what to do. Should i be concerned??
Has anyone with the same issue had any feedback??

Worried!!

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Hanniel said on 06 July 2013

Littlemisslogical I had the same experience! I've been on the microgynon pill for 18 years and never had a problem. I'm 35 now and just missed three periods in a row. Been to see dr three times, she laughed when I asked 'could I be pregnant' and basically shrugged and said missed periods happen sometimes!???
Did you get an answers? Finally got her to book me an ultrasound but on a 6 week waiting list!

Starting to get very concerned and thinking the worst ...

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danniamour56 said on 19 June 2013

Hi

I have done 3 home tests and a test at the doctors and all have come back negative but I still havent had my period I came off the pill in dec12 after being on the pill for a number of years and had a regular period for the first couple of months till March13 when it stopped I have been regularly having unprotected sex with my boyfriend. We are trying to conceive but I not sure where to go for advice I have been given folic acid how soon do I go back to the doctors ?

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pranavi said on 25 April 2013

I am 25 and my husband is 33 we are trying to conceive but my periods are irregular and my lasy period was on 17 dec 2013 ,had ultrasound scan and was told that i have cyst on my ovaries ,what treatment will be best to me regulate my periods and conceive .please help me i'm very much worried about having a baby.

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Worriedxxx said on 14 February 2013

Hi I am 64 days late on my period so not had one for 64 days! I have had several negative pregnancy tests .. Around 25 days late I had a few syntoms of pregnancy I belive but I have got it into my head I'm not pregnant as I have also had a neg blood test. Last night (14.02.13) I started lightly bleeding then this morning realised its gotten very bright red and a bit heavy. Now (14.02.13) (nighttime) I am getting really bad pains ,cramps in my lower abdomen and just went to the loo and wiped and the blood is really bright red with blood clots in. I am really worried and thinking if I am actually preg there is something wrong. Would really like some advice is women been through this.

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Littlemisslogical said on 14 February 2013

I went to my doctors this week having missed 3 periods and not being pregnant. My doctor just shrugged and said it was probably a hormone imbalance, They then just looked at me blankly and said, thanks for coming in.

No blood test, no pregnancy test, no examination.....

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pixieKVF said on 14 January 2013

Hi I am about to turn 40 and have no kids, I have been on the pill pretty much without a break since I was 16. My periods have always been regular lasting for 5 days and I have never had problems. I had one irregular pap test a few years ago which resulted in having some abnormal cells removed through a loop incision which has left my uterus scarred so an IUD is not my best option. My pap smears since have all come back good.
My concern is that my last 5 periods have been very abnormal or non existent, a Doctor check up and an ultra sound came back normal.
Why are my periods suddenly stopping altogether or lasting just 1-2 days, I have just missed yet another period, I have always taken the week break in my pillpack (sugar pills) I never continue my pills to skip a period, I have had several pregnancy tests that all came back negative....concerned!

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GeorgieNthomas said on 08 January 2013

Hello I am 20 years old and i didn't have a period for 6months then on the 7th month i came on my period it didn't last as long as it should have it was for 3Days,
then i missed another 2 and now i have finally become regular i think.
Me and my partner have been trying for a child for almost 2 years & have still not conceived.
I went to my GP to see if i could get a referral to a fertility centre to see if i was able to conceive and my GP told me she can not refer me until i loose weight.
I think this is discriminating and disgusting.
I always see people bigger than me with children and I mean its not like im not healthy I'm a size 12 UK 10stone.
If anybody has any sort of advice for me i would be happy to hear it.

Thanks.

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confusedwomen123 said on 09 June 2012

i am nearly 21 and stop taking the pill 14 months ago recently my periods have gone from every 28 days to every 42 me and my partner realy want a child but i am still not pregnent could ther b somethin wrong with me for my periods to just change my doctor said it was all normal but a cant help thinking its not please help me

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niti786 said on 15 February 2012

hi dere,actually i came from pakistan(hot region country) to UK in october 2011...my period date was due by 6 nov bt it started on 16th nov and last up-to 6 Dec 2011...firstly for intial 5 days i just hav black clotts and on 22nd i see da jelly like lump n red color blood flow....my problem is from 6th Dec., my next date of period should me in Dec sum date bt i haven't started period yet...means i didn't get my periods for last 2 months...i visited doc.bt she said because of weather changing it happening...today after having sex i see the black clot again n its just started with black clots bt dey r like so minor...and now its 24 hour n i its just so slow..or should i say slowest that my pad isn't full...before in pakistan i use to have a heavy periods n suffer da cramps or pain on da 1st n 2nd day....can anyone plz guide me wots dis...???

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tattttt said on 11 October 2011

Hello I am 22 now, currently my period has a sudden change, it becomes longer, its more than 17 days already....who can I consult ? is there any Gynaecology service that can help??????

or is my case is normal?

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megan123 said on 20 May 2011

Somebody please help! I had my baby boy 8 months ago now after i had him i had two very normal periods and then i decided to go on the contraceptive implant . Biggest mistake. i had the implant taken out about 3 months ago now and i haven't had a period , my periods have always been regular so i am really worried that something is wrong with me now. I went to my GP who wasn't massively helpful, he just said no this is not normal and he gave me some medication to bring my period but i am abit reluctant to take them as putting stuff into my body is what got me in this pickle in the first place, the most worrying thing he said though was if i haven't had a period i haven't been ovulating, please help i can't stop thinking about this x

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loopylou231 said on 02 April 2011

I have PCOS and have been trying for a baby for almost a year and half. i have no periods at all unless i take the pill, ive been on clomid to try make me ovulate but one which gave me a period but now even tho i am still on the comid my periods have stoped again i dont understand the way my body works at all.

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mrskhan said on 23 March 2011

Hello We are trying for baby since 9 months. During these 9 months, every month i had late period (3 t0 8 days). Now again my period is late by 11 days but negative preganancy test. I went to GP and she did my urine test and also ultra sound scan, she said everything is ok. I dont know whats the problem with me. could you please comment on that? thanks

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Kathryn at NHS Choices said on 19 January 2011

Drama in Pajamas

Good point!

This article has now been included in the women 18-39 section also.

Kathryn Bingham, Live Well Editor

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Drama In Pajamas said on 12 January 2011

Why is it that this article: "Periods: do I need a doctor?" is a feature for the Women's health aged 40-60 and not for women aged 18-39.

Do you think it's impossible for younger women to need to see a doctor about periods?

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chichevache said on 12 January 2011

A helpful article, but just to point out that some women taking some kinds of HRT tablets to control menopause symptoms may experience a monthly bleed. My doctor and I managed to get into some confusion over this.

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Bug2010 said on 07 July 2010

It is encouraging to see that some NHS webpages are starting to use the somewhat less negative term 'secretions' to describe the normal fluids present during the menstrual cycle, rather than the negative and medicalised 'discharge'.

'Discharge' suggests an unpleasant infection of some kind, and is not a helpful description for women, indeed it can make them feel embarrassed about their bodies and normal processes.

At school in the 1990s I was taught about menstruation but not about the menstrual cycle as a whole. I feel strongly that schools should teach not just about menstruation, but also about the normal cervical fluid which is present in varying amounts and types throughout the menstrual cycle. Those in charge of education policy - please consider this!

Men get their own term to describe seminal fluid which is 'semen'. It seems unfair that women's similarly normal and healthy cervical fluid is relegated to a description of 'discharge'. Can we all start calling it 'cervical fluid' please? NHS, teachers and textbook writers - it's time this was put right!

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