Hesperian Health Guides
Problems with Monthly Bleeding
Heavy monthly bleeding, or bleeding that lasts a long time
- Monthly bleeding is heavy if a pad or cloth is soaked through in less than one hour.
- Monthly bleeding is long if it lasts for more than 8 days.
- Blood clots (soft, dark red, shiny lumps in the blood that look like liver) are also a sign of heavy bleeding.
- Heavy bleeding that goes on for many weeks, months or years can cause weak blood (anemia).
IMPORTANT! See a health worker trained to do pelvic exams if you have
heavy bleeding and:
- blood gushes from your vagina.
- monthly bleeding has been heavy and long for 3 months.
- you think you might be pregnant.
- you have severe pain with the bleeding.
Light monthly bleeding
Light bleeding each month is not a health problem.
- Some family planning methods—like injections, implants, and the pill—can make you bleed less after you have been using them for some time.
- Your ovaries may not have released an egg.
Monthly bleeding that comes too often, or bleeding at other times
Something may be wrong if monthly bleeding comes more often than every 3 weeks, or if it comes and goes without a regular pattern.
Hormonal family planning methods such as pills, implants, or injections, can change monthly bleeding.
- The ovary may not have released an egg.
- There may be growths (fibroids or polyps) or cancer in the womb, especially if monthly bleeding is heavy and not regular.
- Some family planning methods—like the pill, implants, and injections—can cause you to bleed more often.
When Monthly Bleedings Come Too Far Apart, or Have Stopped
Monthly bleeding usually comes about every 21 to 35 days. It may be normal to have an even longer time between bleeding. But something may be wrong, or you may be pregnant, if your monthly bleeding does not come at all.
If you are over 18 and have never had a monthly period, get medical help.
- You may have a serious illness—like malaria, tuberculosis or a worsening HIV infection.
- If you are over 40 or 45, you may be nearing menopause.
- Some family planning methods—like the pill, implants, and injections—can make monthly bleedings come far apart.
- Poor nutrition may change monthly bleeding.