Is this normal? Your period in your 20s, 30s and 40s

Let’s talk menstrual cycles. Despite half of the world’s population experiencing these cycles, we still whisper about them.

What happens during your menstrual cycle? 

The menstrual cycle is typically 4 weeks long and starts with the first day of bleeding and ends when the next round of bleeding begins. During that time, your ovaries are releasing an egg and producing hormones that tell your uterine lining to thicken in preparation for the possibility of a pregnancy. When the egg does not get fertilized, the lining thins and flows out of your body, giving you your period, which is the release of blood from your uterus.  

Your cycle is always changing. Let’s take a closer look at what an average menstrual cycle looks like and what to expect from your period as you mature through the decades. 

Menstruation during teens to early 20s

• The average age for a girl to get her first period is 12.  
• The average cycle length can be 21 to 45 days. 

Typical period 

• Bleeding will last from 2 to 7 days.

You typically need 3 to 4 pads or tampons a day during your period. If you are bleeding through one heavy or super absorbent tampon an hour, that is considered heavy flow, and you should see a gynecologist.

If you feel cramping, ibuprofen can be helpful if the discomfort or pain is uncomfortable. It is best to take it a few days before your period.  For girls and women experiencing extreme pain from cramping, birth control pills can also be an option. They impact estrogen and progesterone levels, leading to a lighter uterine lining and milder cramps. For more suggestions read 7 Ways to Make Periods Less Painful. 

Signs of irregular period

Your cycle is irregular during this time because your body is still figuring this thing out. Your hypothalamic pituitary ovarian axis is still learning.  

• This is the process in which your brain tells your pituitary gland to release the hormones that stimulate your ovaries to ovulate (release an egg).  

• It takes 3 or 4 years for the system to get into a good rhythm. 

• This irregularity can make it hard for teens and young women to determine when to take ibuprofen to offset the discomfort and pain from cramps. 

Menstrual cycle in late 20s to early 30s

• The average cycle length shortens to 21 to 34 days.

Your cycle changes, as that hypothalamic pituitary ovarian axis finds its rhythm, and follows a more consistent pattern. 

Typical period

• Bleeding continues to range from 2 to 7 days. 

The feel of your period may change. Some women, who feel pain in their back as bleeding approaches, may begin to feel more cramping instead. 

Signs of an abnormal period

• An increase in blood flow, along with feelings of dizziness, lightheadedness and fatigue may be signs of anemia. 
• An increase in pain in your lower abdomen could be an indication of: 
  • Fibroids: non-cancerous tumors growing around or in the uterus. 
  • Endometriosis: tissue much like the uterine lining grows outside the uterus causing pain.  
  • Adenomyosis: this is where the lining of the endometrial cavity grows into the muscular wall of the uterus.  
• Late or missed periods could be an early sign of pregnancy or may be caused by polycystic ovary syndrome (PCOS), especially if missed periods are accompanied by excess hair growth, weight gain and high cholesterol.
  • PCOS is a hormonal imbalance that occurs during reproductive years and causes cycle irregularities, infertility and weight gain. 

Menses during late 30s and 40s

• The average cycle length is 21 to 34 days.

You may notice your average cycle lengths becoming irregular again including shorter or lighter cycles with heavier bleeding.

Typical period

• The average bleeding time is 2 to 7 days.

During this time, you can also expect some variation in the number of days of bleeding or the amount of flow. Some cycles may be skipped and then followed by a heavy cycle.

The early 40’s to mid-40s are considered the peri-menopausal years. You may notice the flow of blood from your menses become lighter or heavier.  As you reach the end of your reproductive years, your ovaries produce lower levels of estrogen and progesterone, and they may not release an egg every month. This means lower levels of these key hormones.

Signs of an abnormal period

• Heavy flow, bleeding through one heavy or super absorbent tampon or pad an hour, could be a sign of trouble. Visit your gynecologist to ensure it is not endometrial cancer or other benign causes such as endometrial polyps, uterine fibroids or adenomyosis. It is also important to stay up to date with your pap smears as cervical cancer can also cause heavy bleeding. Cervical cancer is most commonly caused by the Human Papilloma Virus (HPV).  
  • Endometrial cancer develops in the lining of the uterus. Risk factors for this type of cancer include obesity, age and PCOS.
  • HPV is a sexually transmitted disease that impacts the cells of the cervix and causes cervical cancer. 

Menstrual cycle in 50s 

As you reach your 50’s your menstrual cycle will change once again as you experience menopause. Menopause is when you go an entire year without having a period. 

• The average women experiences menopause at age 51. 

What is abnormal?

If you experience any spotting or bleeding after that one year, you should tell your gynecologist. I hope this helps you jump start a conversation about your menstrual cycle.  The best way to make sure your reproductive system is healthy is to visit a gynecologist and get a pap smear