Normal menses or periods are a boon and even slightest of irregularity in monthly cycle can make our life stressful and cumbersome. How to know if your periods are normal or if there is any abnormality? 

Here is a list of abnormalities in menstrual cycle and their causes -

1) Cycle Duration - A normal cycle is defined as the one occurring at regular interval of 21 to 35 days. Any period occurring at an interval of less than 21 days or more than 35 days is abnormal. 

It is called as POLYMENORRHEA if cycles are occurring every month at an interval of less than 21 days. Such periods are quite common in adolescents at the time of puberty when periods start and in women approaching menopause (permanent stoppage of menses) after 40yrs approx. Other causes of frequent menses are intake of i-pill, after abortion or delivery, infection (PID) or cysts (Endometriosis).                         

Menses occurring every month more than 35 days apart, is referred to as OLIGOMENORRHEA. Causes of delayed periods every cycle can be age related (during adolescence and preceding menopause), weight related (excessive weight gain or weight loss), due to too much of stress or exercise, hormonal imbalances like PCOS (Polycystic Ovarian Syndrome), Thyroid abnormality, etc.

2) Menstrual flow - Menstrual flow is regarded as normal if there are no clots and bleeding lasts for 2 to 7 days. Again menses are considered abnormal, if bleeding is unduly scanty and lasts for less than 2 days or if there are clots and flow continues for more than 7 days. 

Menstrual flow unduly, scanty or lasting for less than 2 days is known as HYPOMENORRHEA. Common causes are multiple abortions (D & C's), tuberculosis etc. Decreased flow during periods is usually not alarming if fertility is not the issue. If you have already got kids and completed your family then decreased flow alone is not an issue. But for young women who have plans of achieving pregnancy later on, decreased flow is really alarming. They should definitely consult a gynaec for further investigations.

Presence of clots or bleeding lasting for more than 7 days, is referred to as MENORRHAGIA, a common cause of anemia in women. There are many causes for excessive flow during periods e.g. fibroid, polyps, tumours, cysts, cancer etc. This condition should never be ignored and needs immediate attention.

3) Pain during periods - Painful menstruation of sufficient magnitude so as to incapacitate day to day activities or if there is too much of pain during periods necessitating a painkiller or an injection almost every month, then this is also abnormal. Usually, there is slight discomfort or cramping mostly on first day. If pain lasts for more than 1 or 2 days during periods then this is also abnormal.

Excessive pain during periods is known as DYSMENORRHEA. It can be present since beginning of periods during adolescence (called as PRIMARY DYSMENORRHEA) or sometimes, menses may become painful later on in life in 3rd or 4rd decade (SECONDARY DYSMENORRHEA).

Primary dysmenorrhea is quite common and usually cured on its own following pregnancy and vaginal delivery. Pain killers may be taken now and then for its relief. In cases pain becomes more and more severe every month, immediate consultation should be sought from a gynaecologist as rare cause of such a pain can be abnormal uterine anatomy (Rudimentary horn) etc.

Secondary dysmenorrhea should not be ignored as it is mostly caused due to fibroids, polyps, adenomyosis, infection etc. Immediate Gynecologist consultation should always be done.