People who are assigned female at birth typically get their first menstrual period by ages 12 to 13. The average age of menopause, which is the end of your menstrual cycles, is 51. Between your first period and menopause, your body may be able to carry a pregnancy and have a baby.

Menstrual Flow

"Generally speaking, having a period here and there that is lighter than others, or a month that is heavier than others is not a worrisome change," says Northwestern Medicine Obstetrician-Gynecologist Arjeme Denise Cavens, MD. "What is more important is recognizing patterns or persistent changes in your monthly period and reporting them to your gynecologist."

Light Flow

Some people have relatively light periods. They may only bleed for a few days, and may not even require a pad or tampon. This is often the case for people using birth control methods like oral hormonal pills or intrauterine devices (IUDs). While a light flow is OK, you should reach out to your primary care physician or gynecologist if you go two to three months without having your period.

Heavy Flow

Heavy bleeding can sometimes be related to medical conditions or concerns like bleeding disorders, uterine fibroids and uterine polyps. Heavy bleeding with an irregular pattern may indicate a thyroid or hormone disorder. 

Flow Color

"The color of your period is more typically related to how much you are bleeding," says Dr. Cavens. "The color of your period is not generally an indicator of your overall health."

• Bright red blood may mean more consistent, steady flow.
• Darker red blood, or a light flow of brown to black blood, may indicate old blood, or a slower flow, meaning it takes longer for the menses to travel from your uterus out of your vagina.
• Pink-tinged discharge could mean there is not a large volume of blood.
• Flow with an orange or yellow hue can be normal and does not indicate any health issues.

Spotting

Spotting between your periods or spotting after sex is not always cause for concern. However, you should always discuss the extra bleeding episodes with your physician to ensure a workup for any issues.

Spotting may be related to:

• The type of birth control you are using
• Structural changes like a polyp on your cervix or inside your uterus
• Uterine fibroids
• Abnormal growth of tissue or cancer inside the uterus
• Hormonal dysfunction
• Friction to the vaginal tissue

Timing

Some people think your period should come exactly every 28 days, but that is not the case for most people. Cycles can vary from month to month. A normal menstrual cycle comes somewhere between every 21 and 35 days. 
What is not normal:

• Bleeding too frequently, for example every two weeks
• Skipping multiple months of your period in a row

Cycle abnormalities may be related to:

• Hormonal changes
• Structural issues in your uterus
• Medications

You can regulate the timing of your cycle with birth control. Talk to your gynecology clinician if your cycle is coming too frequently or not regularly enough.

Other Period Symptoms

Many people will experience symptoms around the time of their period, including cramps, mood changes, body aches and fatigue. Most often these symptoms are normal, but if they start to interfere with your everyday life, you should discuss them with your physician.

Fatigue that is more pronounced during your period, or that lasts beyond the days when you have your period, could be a sign of anemia, or low iron levels in your blood. It could also mean you have a thyroid or hormonal disorder.

Cramping is normal with your period. But extremely painful cramps may indicate that you have endometriosis or uterine fibroids.

Mood changes that impact your daily life may be caused by premenstrual syndrome, known commonly as PMS, or premenstrual dysphoric disorder, which is similar to PMS but causes more serious symptoms, such as severe irritability, depression and anxiety.

"It's always important to mention any bothersome symptoms of your period to your clinician to determine what is normal for you and what may warrant further workup or treatment," says Dr. Cavens.

What You Can Do for Your Cycle Health

A healthy body weight, diet and exercise are imperative for cycle regularity and reproductive health. Being overweight or underweight can lead to hormone changes that cause cycle irregularity.

Stress can also impact your cycle, leading to temporary changes in your monthly period.

Monitor your menstrual cycle and report any changes or symptoms that are affecting your life to your gynecologist or primary care physician.