Many tween girls can’t wait for their period to start. It signals a shift from childhood to adulthood that many adolescent girls desperately want.

Menstruation is different for everyone. Some experience painful periods (dysmenorrhea), uncomfortable bloating and disruptive mood swings, while others barely notice the signs of an approaching period.

After 30 years of monthly periods, however, many women are eager for the next phase of life—menopause—to begin.

Even that transition comes with some disruption. It’s a lifelong rollercoaster ride. All of it—the ups and downs and everything in between—is mostly normal.

So what isn’t normal? Here’s what to expect at each age, and what symptoms should sound an alarm.

Adolescence

Girls usually get their first period between 12-13 years old, and about 1.5-3 years after breasts start to develop.

If a young girl has not had her first period by age 15 or within three years of breast development, she should be evaluated by physician.

Irregular menstruation is normal at first, with as many as 6 months passing between periods. Most cycles are between 21-45 days, and shorter or longer cycles may occur. By the third year, most menstrual cycles are that of a typical adult woman: 21-34 days long and each period lasting for 2-7 days.

20s-30s

In their 20s and 30s, women have more consistent periods and ovulate regularly. Women may develop more symptoms, like PMS, cramps and breast tenderness. Women who are sexually active and/or who are over 21 should see their gynecologist or midwife yearly for routine checkups and screenings.

The menstrual cycle can change after having a baby. Normally, a period won’t return until 6 weeks after delivery. If breastfeeding, it may not return until you stop—even if you breastfeed for a year or more.

It’s different for everyone. Some women have heavier, longer or more painful periods after pregnancy, while others have fewer period symptoms.

40s

In their 40s women will start to experience some cycle and symptom changes that may seem irregular, but aren’t.

Welcome to perimenopause: The period of time leading up to menopause that can last from a few months to more than 10 years.

The most common symptom of perimenopause is the change in your menstrual cycle. You may have periods that are longer, shorter, heavier or lighter than usual, or you may begin to skip periods. You may also experience hot flashes, sleep issues, weight gain, vaginal dryness, urinary issues and emotional changes.

50s

In their 50s, most women will experience menopause—a time when a woman’s ovaries stop ovulating and producing enough hormones, leading to no periods for more than a year.

Menopause may be accompanied by hot flashes, vaginal dryness and other symptoms.

The average age of menopause is 51, but it normally occurs between ages 45-55. Women often begin menopause about the same age as their mothers.

Women who have had more babies tend to have later menopause. Tobacco users may have menopause earlier. Ethnicity can also impact age of menopause—African American and Hispanic women tend to have earlier menopause than Caucasian women.

Pay attention to these symptoms

Your period is a good indicator of what’s going on with your body and your overall health. Alert your doctor if you notice any of these potentially serious symptoms:

• Pelvic pain/abdominal discomfort. Constant pain could signal uterine fibroids or endometriosis. Sharp pelvic pain may be a sign of an infection, a ruptured ovarian cyst, or an ectopic pregnancy.
• Bleeding between periods. Occasional spotting happens, but let your doctor know if mid-month spotting keeps occurring, lasts for days, or is heavy and painful. It could signal an injury to the vagina, a miscarriage, or even cancer.
• Heavy periods/missed periods. Let your doctor know of any unusual changes to your cycle, such as unusually heavy periods (e.g., having to change your pad/tampon every hour), or bleeding that lasts longer than a week. Irregular or missed periods can be normal at times but may indicate a medical condition that needs to be addressed.
• Postmenopausal bleeding. If you start bleeding after menopause, tell your doctor. This can be a symptom of cervical or endometrial cancer.

Penny Feldmann, APRN-CNM is a certified nurse midwife with Edward-Elmhurst Medical Group. View her profile and schedule an appointment online.

Not only do our midwives deliver babies and provide care for moms-to-be, but they also offer well-care services for patients of all ages and at all stages of life. Learn more about midwifery at Edward-Elmhurst Health.

We were there for that and we’re here for everything else. At Edward-Elmhurst Medical Group, with providers in 30 specialties from pediatrics to orthopedics to internal medicine, we believe that better relationships lead to better care. Here, it’s personal. Because we take the time to get to know you. Find the perfect doctor.

Read this Healthy Driven Chicago article: What is abnormal uterine bleeding?