Abnormal menstruation can be characterized into different types, like a late period, heavy period or long period. These changes may be a sign of a health condition like endometriosis, fibroids, hypothyroidism or even cancer.

However, these changes in menstruation can also be related to less serious causes, such as stress, weight loss or malnutrition. They may be also be an expected finding, if they occur during certain times, like around puberty or close to menopause.

It is important to consult a gynecologist if you notice any types of abnormal menstruation to determine if there is an underlying cause that can be treated.

What are signs of abnormal menstruation?

Signs that your period may not be normal include:

1. Late period

A late period is typically characterized by a period that takes over 35 days to start. This change is more common in adolescents who have recently had their first period or in women who are close to menopause. In these situations, a menstrual cycle can last for more than 45 days, which is referred to as oligomenorrhea.

However, stress, anxiety, poor diet, intense physical exercise or weight loss can also cause delays in menstruation. Furthermore, the possibility of pregnancy should always be considered if a period is late. Late periods may also be related to another health condition, like polycystic ovary syndrome, hypothyroidism or hyperprolactinemia.

What to do: A period that takes more than 35 days should be be assessed by a gynecologist, to determine the underlying cause and to assess the possibility of pregnancy.

2. Long period

A long period, known as menorrhagia or hypermenorrhea, is characterized by a period that lasts more than 7 days. It can be caused by normal hormonal changes that occur during puberty or pre-menopause, or it can be related to a health condition like endometriosis, myoma or hypothyroidism.

What to do: it is important to consult a gynecologist if your period lasts for more than a week to determine what can be causing it, and to initiate treatment as needed.

3. Heavy period

A heavy period, also called menorrhagia, occurs when a woman has a very heavy menstrual flow. It is associated with heavier bleeding that requires multiple pad or tampon changes.

Heavy periods may be caused by uterine fibroids, the use of a copper IUD, intrauterine polyps, the use of anticoagulants or a previous clotting disorder.

What to do: Intensely heavy periods should be assessed in a hospital setting right away, especially if your heavy flow is accompanied by shortness of breath, palpitations and dizziness. If you experience mild to moderate heavy periods, be sure to speak to your doctor, as a heavy flow can lead to anemia. The doctor may prescribe medications like anti-inflammatories or estrogen-based medications to reduce flow.

4. Brown period

A brown period with dark blood and/or coffee grounds is not usually a sign of any specific condition. It typically occurs at the end of a menstrual cycle, right before a period, and is usually a sign of older blood being expelled.

A brown period can also can also occur in women who use a contraceptive implant in the arm, or it can be a side effect of the morning after pill, or from switching from one oral contraceptive pill. Other causes of a brown period include stress, pre-menopause, polycystic ovary syndrome, or miscarriage.

Read more about why period blood can be brown.

What to do: A brown period may be related to a normal condition, like the end of menstruation or the use of contraceptives, and does not require any specific treatment. However, it is important to see a gynecologist if you suspect pregnancy, if your period is late or if the brown bleeding occurs outside of your expected period.

5. Irregular period

A menstrual cycle generally lasts for 21 to 35 days, with a period occurring at around the same time every month. An irregular period is one that does not start when expected, and starts before 21 days or after 35 days every month.

Generally, this change is common in adolescents, in their first 2 years of menstruation. It is also an expected finding in women who are approaching menopause. However, an irregular period can also be caused by stress, anxiety, inadequate diet, intense physical exercise and weight loss.

Other conditions that can lead to irregular periods include using or changing birth control, polycystic ovary syndrome, endometriosis and uterine fibroids.

What to do: If your periods are persistently irregular, you should see a gynecologist for assessment. It is also important to maintain a balanced diet, to exercise regularly, and to manage your stress levels.

6. Light period

A light period is normal for women who take birth control. It can also be a part of the woman's natural aging process and may be a sign of pre-menopause. These are expected findings that do not require intervention.

In other cases, a light period may be caused by stress, excessive physical activity, cervical stenosis, or hormonal changes due to polycystic ovary syndrome or hyperthyroidism

What to do: It is important to maintain a balanced diet and active lifestyle. However, persistently light periods with no obvious cause should be assessed by a gynecologist to rule out any underlying health conditions.

7. Short period

A normal period usually lasts for 4 to 7 days, however some women may experience a short period that lasts for 3 days or less.

Most times, a short period is not a sign of a health condition, especially if periods are regular and always last for a short amount of time. However, if a short period occurs spontaneously, it may be a sign of a hormonal change, polycystic ovarian syndrome, stress, starting birth control or even pre-menopause.

What to do: Short periods that occur suddenly and are different from your previous periods should be assessed by your gynecologist.

8. Painful period

A painful period, also called dysmenorrhea, generally occurs due to increased contractions in the uterus, This is uterus' way to eliminate the endometrium, which is the inner layer of the uterus.

Although it is common for a woman to experience some discomfort or mild cramping during menstruation, very intense cramps and pain may be a sign of another health condition like endometriosis, uterine fibroids, pelvic inflammatory disease or polycystic ovarian syndrome.

What to do: Very painful periods that interfere with your activities of daily living (e.g. sleeping, working, going to school, etc), should be assessed by your gynecologist, who can help to treat any underlying health conditions and prescribe medications to manage discomfort. Your doctor may consider recommend using anti-inflammatories and/or birth control to relieve pain.

9. Period with clots

A period that presents with clots can occur with hormonal changes, like increases in estrogen. Higher estrogen levels can make the endometrium firmer and can cause clots or lumps to appear during menstruation.

Although this finding is generally normal, it may also be related to other health conditions, like endometriosis, anemia or a myoma, for example. A period with clots can also be a sign of miscarriage. Read more about the difference between a miscarriage and a period.

What to do: Most times, a period with some clots is not a concern. However, heavy bleeding with clots, intense pain, dizziness and weakness should be assessed urgently in a hospital setting.

10. Bleeding outside of your period

Bleeding that occurs outside the menstrual period is also called metrorrhagia, spotting breakthrough bleeding. This bleeding may occur more than once a month and appear at irregular intervals.

It is common for there to be some bleeding in the first three months of using birth control, or if a woman forgets to take her birth control at the correct time. However, bleeding outside of a period can also be a sign of another health condition, like cancer, uterine polyps, fibroids, blood clotting diseases, pregnancy and miscarriage.

What to do: If breakthrough bleeding occurs frequently with no obvious cause, you should see a gynecologist for assessment to rule out another underlying gynecological condition.