What causes prolonged periods and how to treat them?

Symptom Database

Menstruation is a natural process that occurs in women of reproductive age. It involves the shedding of the uterine lining, resulting in bleeding that typically lasts for a few days. However, some women experience prolonged periods, also known as prolonged menstrual bleeding or heavy menstrual bleeding. This can be a cause of concern and discomfort, but understanding the causes and seeking appropriate treatment can help alleviate the symptoms.

What are prolonged periods?

Prolonged periods refer to menstrual bleeding that lasts longer than the average duration, which is typically around five to seven days. Women experiencing prolonged periods may have to endure bleeding for more than a week, sometimes even up to two weeks or more. This can be accompanied by heavy flow, requiring frequent changing of sanitary products.

Causes of prolonged periods

There are several factors that can contribute to prolonged periods. Understanding these causes can help in identifying the appropriate treatment options:

Hormonal imbalances

One of the common causes of prolonged periods is hormonal imbalances. Fluctuations in hormone levels, particularly estrogen and progesterone, can disrupt the normal menstrual cycle and lead to excessive bleeding. Hormonal imbalances can occur due to various reasons, such as polycystic ovary syndrome (PCOS), thyroid disorders, or certain medications.

Uterine fibroids

Uterine fibroids are noncancerous growths that develop in the uterus. These growths can cause heavy and prolonged menstrual bleeding. Fibroids can vary in size and location, and their presence can lead to an irregular menstrual cycle and prolonged periods.

Endometrial polyps

Endometrial polyps are abnormal growths that form in the lining of the uterus. These polyps can cause heavy and prolonged menstrual bleeding. They are usually noncancerous but can lead to discomfort and irregularities in the menstrual cycle.

Adenomyosis

Adenomyosis is a condition in which the tissue that lines the uterus grows into the muscular wall of the uterus. This can cause heavy and prolonged menstrual bleeding, along with severe cramping and pain. Adenomyosis is more common in women who have had children or are in their 40s or 50s.

Other factors

Other factors that can contribute to prolonged periods include certain medications, such as blood thinners, intrauterine devices (IUDs), and pelvic inflammatory disease (PID). Additionally, certain lifestyle factors, such as excessive stress, extreme weight loss or gain, and intense physical activity, can also affect the regularity and duration of menstrual bleeding.

Treatment for prolonged periods

The treatment for prolonged periods depends on the underlying cause. It is essential to consult a healthcare professional for an accurate diagnosis and appropriate treatment options. Some common treatment approaches include:

Hormonal therapy

Hormonal therapy, such as birth control pills or hormonal intrauterine devices (IUDs), can help regulate the menstrual cycle and reduce heavy bleeding. These methods work by balancing hormone levels and preventing the overgrowth of the uterine lining.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs, such as ibuprofen, can help reduce menstrual pain and decrease blood flow. These medications work by inhibiting the production of prostaglandins, which are responsible for uterine contractions and inflammation.

Surgical interventions

In cases where the underlying cause of prolonged periods is uterine fibroids, endometrial polyps, or adenomyosis, surgical interventions may be necessary. Procedures such as myomectomy (removal of fibroids), polypectomy (removal of polyps), or hysterectomy (removal of the uterus) may be recommended to alleviate symptoms and restore normal menstrual bleeding.

Endometrial ablation

Endometrial ablation is a minimally invasive procedure that involves the removal or destruction of the uterine lining. This procedure is typically recommended for women who have completed their childbearing and wish to reduce or eliminate menstrual bleeding.

When to seek medical attention

While occasional variations in menstrual bleeding are normal, it is important to seek medical attention if you experience prolonged periods or any other menstrual irregularities. Consulting a healthcare professional can help identify the underlying cause and determine the most appropriate treatment options.

It is particularly important to seek immediate medical attention if you experience:

  • Excessive bleeding that requires changing sanitary products every hour
  • Bleeding that lasts longer than two weeks
  • Severe pain or discomfort during menstruation
  • Passing blood clots larger than a quarter

These symptoms may indicate a more serious underlying condition that requires prompt medical evaluation and intervention.

Conclusion

Prolonged periods can be a distressing experience for women, but understanding the causes and seeking appropriate treatment can help alleviate the symptoms. Hormonal imbalances, uterine fibroids, endometrial polyps, adenomyosis, and other factors can contribute to prolonged menstrual bleeding. Treatment options include hormonal therapy, NSAIDs, surgical interventions, and endometrial ablation. It is important to consult a healthcare professional for an accurate diagnosis and personalized treatment plan. Remember, if you experience excessive bleeding, severe pain, or other concerning symptoms, seek immediate medical attention for proper evaluation and care.

Haroon Rashid, MD
Rate author
Urgent Care Center of Arlington, VA
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