Johns Hopkins All Children's Hospital

Heavy or Abnormal Periods

Treatment options are available to help manage heavy or abnormal periods.

What Is A Normal Period?

  • Regular period: A normal cycle lasts between 21–35 days, most women bleed for three to seven days and have about 30–40ml of  blood loss.
  • Irregular periods: Cycles outside of  the normal range, missed cycles, or prolonged cycles are considered abnormal.
  • Menorrhagia: Large amounts of  blood loss during periods (80ml per cycle or more) or lasting longer than seven days.
  • Anovulatory cycles: Periods that occur without ovulation. Most commonly due to hormone imbalance or gynecologic immaturity.
  • Dysmenorrhea: Pain with periods.
  • Polycystic Ovary Syndrome: A common cause of  irregular periods in which the body makes too much testosterone. It can cause increased body hair, acne, weight gain and glucose intolerance.

Treatment Options

Type of Treatment What's In It? How To Take It Common Side Effects
Pain medications 
(Naproxen, Ibuprofen)
Non-steroidal anti-inflammatory drug Every 4-6 hours as needed for pain and menstrual cramping Stomach discomfort
Oral contraceptive pills (Sprintec, etc.) Estrogen and 
progesterone hormones
Take daily, at the same time each day Spotting, headache,
nausea, breast tenderness,
mood swings, bloating
Trans-dermal patch 
(Ortho-Evra)
Estrogen and 
progesterone hormones
Apply patch onto skin
once each week
Skin irritation, 
hyper-pigmentation, nausea
Vaginal ring 
(NuvaRing)
Estrogen and 
progesterone hormones
Inserted into vagina
once a month
Breast tenderness, headaches,
nausea, spotting
Progestin injections 
(Depo-Provera)
Progestin hormone Injection into arm every 3 weeks or 3 months Period irregularities,
headaches, breast tenderness
Implants 
(Nexplanon)
Progestin hormone Inserted into arm, can
last up to 3 years
Irregular bleeding
Intrauterine device 
(Mirena, Skyla)
Progestin hormone Inserted into uterus, can last from 3-5 years Period irregularities/
spotting

Frequently Asked Questions

What happens if I miss a dose of the oral contraceptive pill?

ANSWER: If  you miss one pill, take it as soon as you remember. If  you miss more than one pill, please follow the instructions that came with your contraceptive pills.

If I take hormones, will I still be able to get pregnant later in life?

ANSWER: Yes, all of  these hormones are completely reversible, and their effects wear off  within a few days to a few months after you stop using them.

What if I don’t like the treatment option I chose?

ANSWER: It may take you a few months to adjust to many of  these treatment options, but you can change your mind if  you do not like the method you chose and try something that may work better for you.

These have a lot of side effects! Will I have all of these?

ANSWER: Every person responds to hormones differently, and it’s impossible to know what side effects, if any, you’ll experience until you start the treatment.

Do my parents need to know I’m getting treated?

ANSWER: We encourage you to talk openly with your parent/guardian about your concerns and questions; however, you can receive confidential treatment for birth control, sexually transmitted infections or drug use.

How do I choose the right method?

ANSWER: There is no one-size-fits-all approach to choosing hormones. Talk with your doctor about your goals for starting treatment to help you decide.

Can I stop using these at any time?

ANSWER: Yes. Please ask your doctor about the best way to stop your specific treatment.

Still have questions? Come see us.

Our adolescent medicine team has special training to meet the unique needs of teens. We're here to help guide you and answer any questions you might have.

The information here is not intended to be nor should be used as a substitute for medical evaluation or treatment by a health care professional. This publication is for information purposes only and the reader assumes all associated risks.

Content experts:  Svetlana Kozlovich, M.D., Anna Petrella, M.D., and Jasmine Reese, M.D., M.P.H.

References:

  1. Ott, Mary A., and Gina S. Sicato. “Contraception for Adolescents” Pediatrics 134.4 (2014): e1257-e1281
  2. Neinstein, Gordon, Katzman, et. al. Adolescent Health Care a Practical Guide (5th ed.)
  3. Emans, S. J., & Laufer, M.R. (2012). Pediatric & Adolescent Gynecology (6th ed.) Ch. 3: Abnormal Vaginal Bleeding in the Adolescent. P159. Philadelphia Wolters Kluwer, Lippincott Williams & Wilkins.
  4. The Mass General Hospital for Children and Adolescent Medicine, Goldstein, M.A., 2010 and SH Gray. Menstrual Disorders. Pediatrics in Review. 34;6 1-6 2013