When Will My Periods Become Regular?

I Survived My First Period So What Happens Next?

Your very first period can be a bit traumatic. And for some that is an understatement. Ruined favorite undies and bed sheets are the usual casualties as you try and figure out what type of sanitary product is right for your flow. For some the drama is more intense, think blood stained clothes in public. Ugh!

So, What happens next?

Eventually your period will come roughly once a month. A normal interval for your period is every 21 to 34 days.

Usually your body will keep this interval constant so you will be able to predict when your period is coming. In the meantime I would advise keeping a supply of sanitary products very available, in your bag or school locker, as unpredictability is the norm.

It can take awhile for your period to become regular. This is because of the complex process that has to occur in order for your period to come each month. Structures in your brain called the hypothalamus and pituitary gland need to signal your ovaries to release an egg a process called ovulation.  Ovulation has to occur in order for you to have a regular withdrawal bleed, aka your period.  In fact, it can take 12-18 months for your hypothalamic-pituitary-ovarian axis to mature so that your period becomes regular.  Also, the older you are when your first period comes the longer it may take for your body to establish regular ovulation and therefore regular menstrual cycles and periods.

Bottom line, if you are not ovulating at regular intervals you will not get your period at regular intervals. This is called anovulation and the irregular bleeding that is associated with it is called anovulatory bleeding. This type of bleeding is often heavier than your regular menstrual bleeding will be.

If you are overweight with your BMI in the obesity range, this can further delay the onset of regular cycles.  Maintaining a healthy body weight is very important for many reasons including your menstrual health.

During this time when your body is working to establish regular cycles but these cycles are still coming at unpredictable and irregular intervals the amount you bleed will also be unpredictable. Some days may be light and others may be very heavy. Your bleeding may also last for more days than it will once your cycles become regular. Sometimes this anovulatory bleeding can become very heavy and last for many days more than a normal period.

It is hard to measure the amount of bleeding you are having because everyone has a different idea of what too much bleeding looks like. The best approach is if you think you are bleeding too much or for too long you should discuss it with your healthcare provider.

One of the first questions your healthcare provider will probably ask is,  “Are you sexually active?” That can seem like a strange question when you are complaining of too much vaginal bleeding.

But, it is very important. (Remember once you get your period for the first time it means your body is ready to get pregnant. If you are having sex talk to your healthcare provider about birth control.)

 If you have started having sex your healthcare provider will need to evaluate you to make sure your heavy bleeding is not caused by a sexually transmitted disease, trauma from sex, or because you are pregnant.  Likely you also will be checked to see if you are anemic or if you have low platelets. Having low platelets is called thrombocytopenia and this condition makes it hard for your body to stop bleeding once it starts.

 Most of the time heavy anovulatory bleeding is treated with hormonal contraception. If your bleeding is so heavy that you are very anemic you might have to be hospitalized and get a blood transfusion. If this happens you might also be evaluated for another condition that makes it hard for your body to stop bleeding called Von Willebrand’s disease.

If your periods do not become regular within 2 years after your first period you might have a condition called Polycystic Ovarian Syndrome (PCOS). Other signs of this condition are bad acne excessive facial or body hair and being overweight.

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