A period, also called menstruation, is when you shed the lining of your uterus. It generally occurs every month if you are not pregnant. Changes in your hormones caused by your body not being pregnant signal your uterus (womb) to shed the lining you’ve grown during your cycle.

Some people may experience physical and psychological symptoms before their period. These symptoms are collectively known as premenstrual syndrome, or PMS. Symptoms may also occur during your period.

Not everyone will have symptoms before or during their period. Even for those who do, their symptoms may be very different. Period symptoms can also change over a person’s life, so you may not always experience the same symptoms when you have your period.

When Do Periods Usually Start?

You may get your first period when you are around 12 years old, although anytime between 10 and 15 or 16 is also considered normal. Parents can typically expect their child’s first period to occur around two or three years after breast development.

Frequent Symptoms

Common symptoms of a period include:

  • Pain: Pain is said to be one of the most common period symptoms and affects more than half of the people who get periods. Pain is caused by the uterus contracting, so you may feel it before you even notice any bleeding and it may continue throughout your period.Vaginal spotting or bleeding: Your period starts when you start bleeding. This bleeding can last anywhere from two to seven days. The average person loses about two to three tablespoons of blood during their period.Heavy bleeding or clotting: You have heavy bleeding if you need to change your tampon or pad after less than two hours or you pass clots the size of a quarter or larger. About one in five or 10 million Americans have heavy bleeding each year.

Other symptoms you may have during your period include:

  • Moodiness
  • Trouble sleeping
  • Food cravings
  • Cramps in the lower abdomen and back
  • Bloating
  • Tenderness in the breasts
  • Acne

Rare Symptoms

The following symptoms can be signs of other illnesses, including growths and cancers, hormone-related dysfunction, and bleeding disorders or kidney, liver, or thyroid disease:

What Are the Symptoms of PMS?

Some people may have symptoms prior to their period. The following are common symptoms associated with PMS:

  • Irregular bleeding cycles: This is normal only in your first few years of menstruation and as you enter into menopause. Otherwise, irregular periods can be a sign of an underlying condition, such as eating disorders, certain medications, and chronic or severe sudden stress.
  • Missing periods: Amenorrhea is when you miss your period for three months in a row or for six months if you have irregular cycles. You can also have this condition if you’re female and have reached age 15 without menstruating. A missed period not caused by pregnancy, breastfeeding, or menopause could be a sign of an eating disorder or weight gain or weight loss body trauma, a hormonal condition like polycystic ovarian syndrome (PCOS), a birth defect, or a brain tumor.

Complications

Changing levels of hormones, especially estrogen, are associated with changes in both immune and neuroendocrine systems.

Irregular Periods vs. Abnormal Bleeding

Abnormal or unusual bleeding refers to bleeding outside your typical time of the month. Causes may include:

A 2019 study showed that half of 267 women between the ages of 18 and 50 years old with inflammatory arthritis experienced symptom flare-ups around their menstruation.

The following conditions are also exacerbated by periods:

  • Acne: In an anonymous survey including 105 women ages 15 to 50, 65% of participants reported that their acne symptoms were worse during their periods.
  • Asthma: Perimenstrual asthma (asthma occurring at or around the time of menstruation) is reported to affect between 19% and 40% of women with asthma, and has been associated with more asthma-related emergency department visits, hospitalizations, and treatment.
  • Epilepsy: Approximately half of women in their reproductive years who have epilepsy have an increase in seizures around the time of their period, according to the Epilepsy Foundation. The increase in estrogen secretion after menstruation has been associated with a higher frequency of seizure activity.
  • Irritable bowel syndrome (IBS): IBS commonly co-occurs with PMS and menstrual pain. In one study of 182 women, 17% had IBS, and their average days of bleeding and pain severity were both higher compared with the non-IBS group. Mental health scores were better in the non-IBS group for depression, anxiety, stress, and insomnia or daytime sleepiness as well.
  • Migraines: One data analysis found that of 1,697 women ages 16 to 60 who met the criteria for migraine and menstruation, nearly 60% reported an association between migraines and menstruation.

When to See a Doctor

You know your body best. If something doesn’t feel right, it’s always better to seek medical consultation than to wait for matters to progress.

Talk to your doctor if:

  • You have not started menstruating by the age of 16.Your period stops suddenly.You are bleeding for more days than usual.You are bleeding more heavily than usual.You have severe pain during your period.You have bleeding between periods.You suddenly feel sick after using tampons.You think you might be pregnant (for example, you have had sex and your period is at least five days late).Your period has not returned within three months after stopping birth control pills and you know you are not pregnant.You have any questions or concerns about your period or possible pregnancy.

Summary

Period symptoms generally include bleeding, cramping, bloating, and mood swings. Some people will experience these symptoms, while others may not. These symptoms may also change throughout your life. If you have irregular periods and you are not in puberty or perimenopause, talk to your doctor to make sure they are not caused by an underlying condition.

If you or a loved one are struggling with a mental health condition, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database.

A Word From Verywell

Having your period isn’t all bad. During this time, you can take some time to get in touch with your body and listen to what it needs. Sometimes we are so busy that we forget to slow down and actually take care of ourselves.

When you have your period, make it a time when you take extra-good care of yourself. This may mean nourishing your body, practicing a sleep routine, moving your body, and resting. If you do not feel well, don’t push yourself too hard. If symptoms are getting in the way of living your best life, seek a doctor’s opinion on your treatment options.