There are so many home truths people never tell you about growing older.
Like the fact acne doesn’t always end when high school does and that it’s not uncommon to find yourself with pimples and wrinkles (prinkles?) simultaneously. Or that the search for a rental property is even more disheartening than dating.
To top it all off, adulthood often has another unwelcome surprise in store for those of us who have periods.
It’s easy to assume the worst side effects of menstruation — the sudden breakouts, the monstrous mood swings, the sensation of having been kicked in the ovaries — will calm down when our adolescent hormones do. But that’s not always the case.
A quick poll of my friends revealed many have experienced significant, often sudden changes to their periods as they’ve grown older.
Some experienced minimal or no symptoms during their teenage years, and are now struck down by painful cramps and headaches in their late 20s. For others, the severity has lessened significantly (to their great joy). So what’s going on here?
Watch:Do you have a different name for your period? (Post continues after video.)
Why it happens.
Dr Dasha Fielder of Sapphire Family Medical Practice in Bondi Junction says there are numerous factors that can cause our periods and their side-effects to change throughout our lives — and yes, age is one of them.
“Initially when girls start menstruating in their teens, they have what we call an anovulatory cycle; they don’t actually ovulate, they just menstruate. They’re almost like ‘fake’ periods,” she explains.
“Eventually, after a few cycles, they start to ovulate and their periods become more regular, and that can be more painful.”
Reproductive age can also have an influence; Dr Fielder says our cycles might shift and become longer or shorter after a pregnancy or a miscarriage.
As you might suspect, hormonal changes play a role; periods tend to be more irregular during puberty and when a woman approaches perimenopause (generally around the mid-40s mark) because our hormones are usually more erratic at these times.
Among otherwise healthy women, period changes can be tied to more general lifestyle changes or stressors.
Dr Amanda Newman, a GP with Jean Hailes for Women’s Health explains that travel, weight loss, and excessive dieting and exercise can all impact how regular your periods are and how much blood is lost.
A number of women I spoke to while researching this topic said their periods were significantly different when they stopped using the Pill, and believed it played a role in this shift.
Some women believe stopping the pill alters their period symptoms (Image via iStock)
However, Dr Fielder explains that because hormonal birth control suppresses a woman’s natural menstrual cycle — what you experience each month is a withdrawal bleed, or ‘fake period’ — any change is more likely to be caused by something else.
This is especially true for women who use it for a number of years.
“A lot of women in Australia will go on the Pill at age 18 and then stay on it until 48, with little breaks to have children. Obviously your cycle can be potentially quite different when you’re 18 to when you’re 38, but I don’t think it’s the Pill that’s affected it. It’s your natural cycle change,” Dr Fielder says.
Should I be concerned?
It’s natural for women to experience some variation in their menstrual cycle through their lives, but in some instances it can be indicative of an underlying health issue requiring investigation and treatment.
Dr Newman says abnormal thyroid, liver or kidney function, a pelvic infection, bleeding disorders or changes to the cervix (that cause bleeding between periods or after sex) can be the cause of menstrual symptoms.
There are also several medical conditions that can significantly affect a woman’s menstruation, including polycystic ovary syndrome (PCOS), endometriosis or conditions of the uterus (like fibroids and polyps).
If your periods have changed significantly in terms of how painful and heavy they are, it’s important to see your doctor. A pap smear, examination or ultrasound might be required to determine if any underlying conditions are present.
The treatments available for underlying causes are varied.
Watch: The signs of endometriosis every woman should know about. (Post continues after video.)
"If you have a hormonal problem, then taking the combined oral contraceptive pill can help. If it’s a problem with your uterus then surgery may be needed, or insertion of the progesterone IUD," Dr Nelson explains.
"It’s also important to treat conditions that are associated with period problems, such as iron deficiency, acne, depression, or pain interfering with school or work or social activities."
Although every individual's experience of periods is unique and often subjective, some levels of pain and discomfort are definitely not normal and require medical attention.
"I think a 'normal' experience of a period should be mild cramping that is relieved by Panadol or Nurofen, that doesn't stop you from attending work. It certainly shouldn't be so heavy that conventional pads and tampons can't control the flow," Dr Fielder says.
When in doubt, book in with your GP.
This article originally appeared over on The Glow.