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Menstruation: About Your Period

During puberty, chemical messengers signal your ovaries to make estrogen and other hormones that cause the uterus to grow. The uterus is lined with blood and cells. Hormone changes each month make this lining thicker; when it gets to a certain thickness, the lining sheds into the vagina. This is a menstrual period. Once your period’s over, the lining begins thickening again and the cycle continues.

A girl’s first period typically happens between age 9 and 16. Periods can be irregular during the first few months or years; this is normal. Once your body adjusts, the cycle can be between 21 and 35 days. Not every woman has a period once a month.

Most periods last from three to seven days, but anywhere from one to eight days may still be normal. It may look like a lot of blood, but there are usually only four to six tablespoons in the whole flow. The rest is uterine lining and other fluids.

Many women have pain during their period. Medical professionals call this dysmenorrhea, but it’s more commonly known as cramps. Cramps may be accompanied by:

  • nausea and/or vomiting;
  • dizziness;
  • feeling flushed;
  • diarrhea;
  • fatigue;
  • headaches; and
  • back and leg pain.

Over-the-counter ibuprofen, good nutrition, exercise, and a heating pad or hot water bottle on your lower abdomen can provide relief. If cramps don’t improve, your provider may prescribe other medication.

When to see a provider


See your provider if:

  • cramps don’t get better and interfere with your activities;
  • PMS symptoms are troublesome;
  • your period consistently lasts more than 10 days;
  • you consistently use more than six pads or tampons daily;
  • you skip a period if you’re usually regular, or think you may be pregnant;
  • you become sexually active; or
  • you think you might have an infection.

Your provider will talk with you about any concerns and do a physical exam. If needed, an internal pelvic exam may be done, blood tests ordered or medication prescribed. At the appointment, you may be asked:

  • your age when you had your first period;
  • how often you have periods and how long they last ;
  • how many pads or tampons you use each day;
  • the dates of your last two periods;
  • about cramps or PMS;
  • if you’re sexually active;
  • if you use birth control; and
  • if you take any medication or drugs.

PMS

Premenstrual syndrome, or PMS, is the term for the feelings or physical changes some women have about one to two weeks before a period.

Symptoms include:

  • increased acne;
  • breast tenderness and swelling;
  • fatigue;
  • mood swings;
  • headaches;
  • increased appetite and cravings for sweets/salt;
  • constipation;
  • irritability;
  • weight gain;
  • changes in sex drive; and
  • feeling bloated.

Eat plenty of fresh fruits, green leafy vegetables and whole grains, have high-protein snacks between meals and drink eight to 10 glasses of water a day. Raspberry leaf tea can help relieve abdominal cramping.

Dietary supplements started about 10 days before your period have also been shown to help. These include:

  • calcium: 1500 mg. daily;
  • magnesium: 500 mg. daily;
  • evening primrose oil: 500 mg. two to three times daily;
  • vitamin B complex (especially B-6): 100 mg. two to three times daily;
  • vitamin E: 400 mg. daily; and
  • zinc picolinate: 15 mg. daily.

If PMS symptoms don’t improve, your provider may prescribe medication.