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After a teen has been menstruating for a few years, her menstrual cycle typically becomes more regular. For

most women, a normal menstrual cycle ranges from

21 to 35 days. However, up to 14% of women have irregular menstrual cycles or

excessively heavy menstrual bleeding.

Amenorrhea (uh-men-o-REE-uh) is the absence of menstruation — one or more missed menstrual periods. Women who have missed at least three menstrual periods in a row have amenorrhea, as do girls who haven't begun menstruation by age 15.

The main sign of amenorrhea is the absence of menstrual periods. Depending on the cause of amenorrhea, you might experience other signs or symptoms along with the absence of periods, such as:

• Milky nipple discharge• Hair loss• Headache• Vision changes• Excess facial hair• Pelvic pain• Acne

Menstrual cramps (dysmenorrhea) are throbbing or cramping pains in the lower abdomen. Many women experience menstrual cramps just before and during their menstrual periods.For some women, the discomfort is merely annoying. For others, menstrual cramps can be severe enough to interfere with everyday activities for a few days every month.

Most young women who have dysmenorrhea • Have lower back pain and cramping in the lower area of the abdomen

during their periods• This pain can range from dull to throbbing• Some girls may have other symptoms during their period such as nausea,

vomiting, loose bowel movements/diarrhea, constipation, bloating in the belly area, headaches, and/or lightheadedness, all of which can be mild to severe

Heavy or prolonged menstrual periods, or menorrhagia, are the most common type of abnormal bleeding from the

uterus. Periods are considered heavy if there is enough blood to soak a pad or tampon every hour for

several consecutive hours.

Other symptoms of a heavy period can include:

• Nighttime bleeding that requires getting up to change pads or tampons

• Passing large blood clots during menstruation

• A period that lasts longer than seven days

In severe cases, heavy menstruation can interfere with sleep and daily activities. Blood loss from heavy periods can also lead to anemia, causing symptoms such as fatigue and shortness of breath.

Oligomenorrhea is the term for by light or infrequent menstrual periods. It occurs in women of childbearing

age. Some variation in menstruation is normal. A woman who regularly goes more than 35 days without

menstruating may be diagnosed with oligomenorrhea.

• See your doctor if you go more than 35 days without a period and are not on birth control medication. If your cycle suddenly changes, always contact your gynecologist

• Some women who skip a period experience a heavier one the next time. This is normal and usually does not indicate a miscarriage

• Adolescent girls should see a doctor if they don't begin their period by 15 years of age

Premature ovarian failure — also known as primary ovarian insufficiency — refers to a loss of normal function of your ovaries before age 40. If your ovaries fail, they don't produce normal amounts of the hormone estrogen or release eggs regularly. Infertility is a common result.

Premature ovarian failure is sometimes referred to as premature menopause, but the two conditions aren't exactly the same. Women with premature ovarian failure may have irregular or occasional periods for years and may even become pregnant. Women with premature menopause stop having periods and can't become pregnant.

Signs and symptoms of premature ovarian failure are similar to those experienced by a woman going through menopause and are typical of estrogen deficiency. They include:

• Irregular or skipped periods (amenorrhea), which may be present for years or may develop after a pregnancy or after stopping birth control pills

• Hot flashes• Night sweats• Vaginal dryness• Irritability or difficulty

concentrating• Decreased sexual desire

Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. Also called leiomyomas (lie-o-my-O-muhs) or myomas, uterine fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer.Fibroids range in size from seedlings, undetectable by the human eye, to bulky masses that can distort and enlarge the uterus. They can be single or multiple, in extreme cases expanding the uterus so much that it reaches the rib cage.

In women who have symptoms, the most common symptoms of uterine fibroids include:

• Heavy menstrual bleeding• Prolonged menstrual periods — seven

days or more of menstrual bleeding• Pelvic pressure or pain• Frequent urination• Difficulty emptying your bladder• Constipation• Backache or leg pains

Endometriosis (en-doe-me-tree-O-sis) is an often painful disorder in which tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus (endometrial implant). Endometriosis most commonly involves your ovaries, bowel or the tissue lining your pelvis. Rarely, endometrial tissue may spread beyond your pelvic region.

Common signs and symptoms of endometriosis may include:

• Painful periods (dysmenorrhea). Pelvic pain and cramping may begin before and extend several days into your period and may include lower back and abdominal pain

• Pain with intercourse. Pain during or after sex is common with endometriosis

• Pain with bowel movements or urination. You're most likely to experience these symptoms during your period

• Excessive bleeding. You may experience occasional heavy periods (menorrhagia) or bleeding between periods (menometrorrhagia)

• Infertility. Endometriosis is first diagnosed in some women who are seeking treatment for infertility

• Other symptoms. You may also experience fatigue, diarrhea, constipation, bloating or nausea, especially during menstrual periods

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