There's as much variation in menstruation as there is in women. One sister has her first period at 11, the second at 14. One woman is “as regular as clockwork,” another's cycles fall randomly across the calendar.

There seems to be no rhyme or reason to it. Yet in most cases, this is all perfectly normal.

But when any menstrual symptom — pain, heavy bleeding, spotting, missed periods — begins to interfere with your life, it means you could have menstrual problems, it's time to seek medical attention. Most problems are relatively uncomplicated and respond well to medication or simple surgical procedures. Others could have more dangerous consequences if the underlying cause is not treated promptly. If you have any doubts about your menstrual problems, see your doctor.

Major Menstrual Disorders

Many women experience discomfort (sore, swollen breasts, minor pain in the lower abdomen, nervousness) before their periods. They may also have mild cramps when the menstrual flow starts. In most cases, these symptoms do not interfere with their normal activities and can be alleviated by diuretics (“water pills”) and salt reduction to reduce bloating; plus pain relievers such as aspirin, acetaminophen (Tylenol) and ibuprofen (Advil, Motrin).

For some women, however, symptoms can be more severe, signaling a condition that needs medical attention. These problems include:

• Premenstrual irritability and mood swings (PMS)
• Very painful periods
• Heavy bleeding
• Unusually short or long cycles
• Failure to menstruate
• Early menstruation
• Toxic shock syndrome

Should you experience any of these menstrual abnormalities, consult your doctor. He or she will take a complete medical history, perform a thorough physical examination, and conduct tests to diagnose the cause of the menstrual problems and determine the best course of treatment.