Problems with Monthly Bleeding 361
Monthly bleeding that comes too often,
or bleeding at other times
Something may be wrong if monthly bleeding comes more
often than every 3 weeks, or if it comes and goes without a
regular pattern.
Causes:
• The ovary may not have released an egg (see page 48).
• There may be growths (fibroids or polyps) or cancer in the
womb, especially if monthly bleeding is heavy and not regular
(see page 380).
• Taking the medicine called
estrogen after menopause
(see page 124).
• Some family planning
methods—like the pill, implants,
and injections—can cause you
to bleed more often
(see pages 208, 213, and 214).
When monthly bleedings come too far
apart, or have stopped
Monthly bleeding usually comes about every 21 to 35 days.
It may be normal to have an even longer time between bleeding.
But something may be wrong, or you may be pregnant, if your
monthly bleeding does not come at all.
Causes:
• You may be pregnant (see page 67).
• You may be having a miscarriage (see page 98).
• The ovary may not have released an egg (see
page 231).
• You may have a serious illness—like malaria,
tuberculosis (see page 387) or a worsening
HIV infection (see page 283).
• If you are over 40 or 45, you may be
nearing menopause (see page 124).
• Some family planning methods—like the
pill, injections, and implants—can make
monthly bleedings come far apart
(see pages 208, 213, and 214).
• Poor nutrition may change monthly bleeding
(see page 172).
➤ Hormonal family
planning methods
such as pills,
implants, or injections,
can change monthly
bleeding.
➤ If you are over 18
and have never had
a monthly period, get
medical help.
When a woman
grows older, her
monthly cycle
changes.
Where Women Have No Doctor 2012