What is menstruation?

Menstruation is when the lining of your uterus sheds and flows (or bleeds) out of your vagina. This happens about every 28 days. It is a normal part of the menstrual cycle. This is also known as having a period.

Periods usually come between 21 and 35 days apart. This can vary from person to person and change from cycle to cycle. You can track your cycle length by counting the days from the first day of your period until the first day of your next one.

The menstrual cycle prepares your body for pregnancy and is controlled by hormones from your brain, ovaries and uterus.

What happens during the menstrual cycle?

In each menstrual cycle, an egg develops in one of your ovaries. When it's ready, the egg is released from the ovary. This is known as ovulation. As the egg travels towards your uterus, it can be fertilised by sperm and develop into a pregnancy. During this time, the lining of your uterus thickens, getting ready in case of pregnancy.

If pregnancy doesn't happen, the thickened lining sheds and flows out through your vagina as a menstrual bleed (period). Then, the cycle starts again.

What can I expect during a period?

Menstruation is different for everyone. Most people bleed for 3 to 7 days, with a heavier flow at the start that becomes lighter. Blood can range from bright red to dark brown. You may also see small clots.

You may notice light bleeding (spotting) at other times in your cycle. There are many possible causes for bleeding between periods. This is often harmless but should be checked by your doctor. It may sometimes be something serious.

You may also notice that your vaginal discharge changes in consistency and colour throughout your menstrual cycle.

What does a period feel like?

You may experience period pain, like cramps or aches in the lower part of your abdomen (tummy) or back. You may also feel this pain during ovulation, around the middle of your cycle.

Many people have physical and emotional symptoms before and during their period, such as:

• bloating
• constipation or diarrhoea
• headaches
• breast tenderness and swelling
• acne
• tiredness
• mood swings and feeling irritable

While some people don't have any symptoms, others find it hard to continue with daily life. You may have different symptoms at different stages of your life.

What are period problems?

Period problems can include symptoms that suggest something may not be right with your menstrual cycle. Problems can include:

• heavy bleeding — this can sometimes lead to low iron levels
• severe period pain (dysmenorrhoea) — this may be caused by a health condition, such as endometriosis
• irregular periods
• not getting your period (amenorrhoea)
• bleeding between periods
• premenstrual syndrome (PMS)

When should I see a doctor?

You should see your doctor if you feel something may not be right with your menstrual cycle.

You should also see your doctor as soon as possible if you experience any bleeding after menopause. If you are 17 years old and haven't started to have periods, tell your doctor.

You should also seek medical advice if:

• your periods are heavier than usual
• the pattern of your periods changes
• your periods last more than 8 days
• your periods are less than 3 weeks or more than 2 months apart
• your periods have stopped for more than 6 months and you're not sure why
• you have bleeding between periods or after sex
• you have severe period pain that disrupts your daily activities

You can also talk to your doctor if your periods are affecting your wellbeing or enjoyment of life.

How can I prepare for my appointment?

There are ways to prepare and advocate (speak up) for yourself during your appointment. If you feel your concerns aren't being taken seriously, don't present your symptoms as less intense than they really are.

Here are tips that may help you:

• Keep a list or diary of your symptoms.
• Write down questions to ask your doctor.
• Have key information about your family history ready.

Your doctor should listen to you and take your concerns seriously. If this doesn't happen, you may choose to find a new doctor.

When do periods start?

Females have their first period during puberty. The average age to get your first period is at 12 or 13 years old. However, it can happen as young as 9 years old or as late as 16 years old.

If you have not gotten your first period by the age of 16 or 17 years old, you should talk to your doctor.

When do periods stop?

Periods temporarily stop during pregnancy. Breastfeeding also affects your cycle.

Some people experience a pause in their periods because of:

• changes in body weight
• stress
• lots of strenuous exercise
• hormone problems
• polycystic ovarian syndrome (PCOS)

Some medicines, such as contraceptives, may stop periods. This can be helpful, especially if your period is heavy or painful. After you stop 'the pill' or another contraceptive, it may take a while for your period to come back.

Periods stop completely when you reach menopause. The average age for this in Australia is 51 years old. It is normal for menopause to happen anywhere between 45 and 55 years old.

What products can I use when I have a period?

There are several products to help you manage your bleeding. Your choice may depend on cost, comfort, sustainability and how heavy your period is.

Sanitary pads are attached to your underwear to absorb blood. They come in different sizes and shapes to suit your period. They may be disposable or made from reusable fabric. You need to change your pad every 4 hours or when it's full.

Tampons are placed inside your vagina to absorb blood. These absorbent plugs come in different sizes. You need to change your tampon every 3 to 4 hours or when it's full. Never leave a tampon in for more than 8 hours. This could cause a dangerous condition called toxic shock syndrome. It may therefore be best not to use tampons overnight.

A menstrual cup is placed inside your vagina to collect blood. It uses suction to stay in place. You need to empty it when it's full. Follow the product instructions for removing it to prevent toxic shock syndrome.

Period underwear has a layer that absorbs blood. It can be used alone or in combination with other products.

Here are more tips on how to use your period products and how to be prepared for your period:

• Wash your hands before changing your sanitary products and make sure your products are clean.
• If you are using tampons or disposable pads, wrap them up and put them in the bin. Never flush them down the toilet.
• If you are using reusable pads, rinse them off and put them in the washing machine. Menstrual cups and period underwear can be washed and reused.
• Always follow the instructions on the product.
• Keep a 'period kit' in your handbag or school bag, to be prepared for your period.
• Keep pain-relief medicines and a spare pair of underwear in your bag at school or at work.

How can I care for myself during my period?

There are several ways to take care of yourself during your period. This includes managing physical pain and looking after your mental health

Pain relief

To manage period pain, you can:

• use a heat pack or hot water bottle
• take a warm bath
• exercise
• try relaxation techniques such as yoga or meditation

If you are still in pain, you may want to take pain-relief medicine. Period pain medicines usually work best if you take them before the pain gets bad. Keep some in your bag for easy access during your period. Speak to your doctor or pharmacist for advice.

If you have very painful periods, you may want to speak to your doctor about hormonal methods such as contraception.

Looking after your mental health during your period

You may find that your mood changes and you are irritable at certain stages during your menstrual cycle.

To improve your mood, try to:

• exercise and move your body
• get enough sleep
• eat well-balanced and nutritious meals
• reduce stress and decision making during this time
• do hobbies or activities that you enjoy

You should be able to do all your regular activities when you have your period. If you have sex, make sure to take your tampon out beforehand.

Resources and support

There are several websites that offer helpful resources for managing periods:

• Rosie offers an online space with resources to learn about periods, puberty and self-care down there.
• Get the Facts is a government website where young people can find information about periods.
• Jean Hailes for Women's Health provides information about the menstrual cycle.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Other languages

• Multicultural Centre for Women's Health has facts sheets on menstruation in community languages.
• Planet Puberty guides parents of children with intellectual disability and autism to navigate puberty in community languages.
• Jean Hailes for Women's Health has translated fact sheets in community languages.

Aboriginal and/or Torres Strait Islander peoples

• Yarning about Girls Business has information on puberty for young Aboriginal and/or Torres Strait Islander people.
• Jean Hailes for Women's Health has information on periods for Aboriginal and/or Torres Strait Islander people.

Looking for information for sexually and gender-diverse families?

• TransHub offers resources and provides information about menstruation in gender-neutral language.