Menstrual Health

Menstruation, or a period, refers to the vaginal bleeding that happens monthly for people with female reproductive systems. Each month, the ovaries release an egg, and the body prepares for pregnancy by building up a lining in the uterus.

When pregnancy happens, a fertilized egg implants in the uterus. But if a pregnancy does not happen, then the body sheds this uterine lining through the vagina. In addition to vaginal bleeding, menstruation may be accompanied by other symptoms such as cramping or lower back pain. Menstruation often begins between the ages of 11 and 14.

The American College of Obstetricians and Gynecologists recommends that adolescents should begin routine gynecologic care between the ages of 13 and 15. Whether you are a teen or already in adulthood, our providers can help support your menstrual health and address symptoms that interfere with your quality of life.

A person’s menstrual cycle and period is highly individual — what may be typical for you may not be for someone else. Not every period-related symptom may be cause for concern. However, there are some symptoms that you should discuss with your health care provider.

Particularly heavy periods. For many people with periods, the first day or two of menstruation is marked by heavy bleeding. However, dealing with your period should not consistently interfere with your ability to attend school, go to work or participate in other daily activities. Heavy periods, or menorrhagia, can be a symptom of uterine fibroids, a bleeding disorder or a thyroid problem.

Extremely painful periods. Some cramping and pain are normal. If you can’t control your pain with over-the-counter medications, miss work or school because of period pain, or your period pain gets worse as you get older, it’s time to seek help. We can pinpoint the source of your pain and find ways to lessen its intensity.

Irregular periods. The timing of your period can vary greatly — not every person bleeds every 28 days like clockwork. However, if the time between periods is less than 24 days or more than 38 days, there may be cause for concern. Certain infections, uncontrolled diabetes or thyroid problems can all affect the timing of your period.

Bleeding when not on your period. Any time you bleed when not on your period (including after sex or when in menopause), talk to your provider.

Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). PMS is very common in people with periods — up to 90 percent of people experience some symptoms. Symptoms may include depression, anxiety, irritability, mood swings, bloating and weight gain. If your PMS symptoms are severe, you may have PMDD. We can bring relief and help you manage your symptoms.

If you notice something wrong with your period, keep a log — either in a journal, in a calendar or on an app — of when your periods start and stop, how long they last and what other symptoms you experience. This can help you and your provider figure out what’s normal for you and what might be a sign that something is wrong.

At MultiCare, our gynecologists, midwives and advanced practice providers are equipped to diagnose and treat any problem related to your period. Hormonal birth control is often used as a treatment, but our providers can help you find the best option for you. We can also identify any underlying conditions that may be affecting your period and help get them under control.