Periods vary a lot from person to person, and a little variation from month to month is normal. But periods that are very painful, very heavy, very irregular or absent are common and usually treatable — and they shouldn't be endured in silence. This page explains what is normal, the most common problems, and when to see a doctor. Ayurveda groups these conditions as Artava Vikara, disorders of menstruation.
Each month the lining of the womb thickens in preparation for pregnancy. If no pregnancy occurs, hormone levels fall and the lining is shed as a period. The cycle is counted from the first day of one period to the first day of the next. Periods usually start between the ages of 10 and 16, are often irregular for the first couple of years, and become irregular again in the years before menopause.
| Usually normal | Worth checking | |
|---|---|---|
| Cycle length | 21–35 days | Shorter than 21 or longer than 35 days; varies by more than 7–9 days each month |
| Bleeding | 2–7 days | More than 7 days |
| Flow | Changing a pad or tampon every 3–4 hours at most | Soaking through every 1–2 hours, clots larger than a coin, flooding |
| Pain | Cramps eased by a painkiller or heat | Pain that stops daily activities or school/work |
| Between periods | No bleeding | Bleeding between periods or after sex |
| Absent periods | Pregnancy, breastfeeding | No period for 3 months (not pregnant), or none by age 15 |
A gynaecologist will ask about your cycle — a period-tracking app or diary is very helpful — and may arrange a pregnancy test, haemoglobin, thyroid and hormone tests, and a pelvic ultrasound. Treatment depends on the cause: anti-inflammatory painkillers such as mefenamic acid or ibuprofen for painful periods (best started at the first sign of the period); hormonal treatments to regulate cycles, reduce bleeding and pain; iron for anaemia; lifestyle and medical treatment for PCOS; and surgery for some fibroids, polyps and endometriosis.
Ayurveda considers menstrual blood (Artava) a by-product of Rasa dhatu, and healthy menstruation a sign of overall health. Disorders are grouped as Artava dushti: painful periods (Kashtartava), mainly from obstructed Apana Vata; heavy bleeding (Asrigdara), mainly Pitta; and scanty or delayed periods (Artava kshaya), often Vata and Kapha. The classical menstrual routine advises rest, light warm food and avoiding exertion during the period — sensible guidance, though no one should be excluded from daily life because of menstruation.
Evidence for most herbal menstrual remedies is limited. Some formulations (asava, arishta) contain self-generated alcohol. Avoid herbs if you might be pregnant, and don't use them to delay investigation of heavy or irregular bleeding. Take licensed products on a qualified practitioner's advice.
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Reviewed against NHS: Periods, NHS: Period pain, NHS: Irregular periods, NHS: PCOS, NHS: Endometriosis, NCCIH: Ayurvedic Medicine, and Ministry of Ayush pharmacovigilance. These links support education and do not replace individual medical advice.