Experiencing your menstrual cycle, commonly known as your period, is a very personal experience. What’s “normal” can differ significantly from person to person. Periods can be short and light, lasting just a few days, or they might extend to a week with heavier flow. It’s estimated that up to 14% of individuals who menstruate encounter periods that are heavy, painful, or irregular.
Tracking your own menstrual cycle is key to understanding your body’s rhythm. It helps you identify what’s typical for you and also highlights any changes that might need attention. If you’ve noticed your period is lasting longer than usual, you’re likely seeking answers. Let’s explore nine possible reasons why your period might be lasting longer than you expect.
How Long Should a Period Typically Last?
Firstly, it’s important to establish a baseline for period duration. On average, the menstrual cycle recurs every 21 to 35 days. Within this cycle, menstrual bleeding usually lasts between 2 to 7 days. Remember, “normal” is subjective and varies among individuals. However, consistently heavy or prolonged periods can elevate the risk of anemia.
Menorrhagia is the medical term for periods that extend beyond a week or are unusually heavy. Heavy bleeding is characterized by soaking through pads or tampons in less than two hours, or passing blood clots larger than a quarter. Menorrhagia can increase the likelihood of developing anemia, a condition where the red blood cells are deficient in carrying sufficient oxygen to your body’s tissues.
If you’ve been experiencing heavy or prolonged menstrual bleeding, it’s advisable to consult with your healthcare provider. They can assess whether you should be tested for anemia. Managing anemia might involve dietary adjustments to include iron-rich foods like red meat, spinach, and poultry, iron supplements, or other treatments as recommended by your doctor.
What Factors Can Cause Prolonged Periods?
Several factors can contribute to periods that are heavier or longer than what you typically experience.
Hormone Imbalances and Ovulation Changes
Hormones are the primary regulators of the menstrual cycle. When hormonal equilibrium is disrupted, it can lead to alterations in menstrual bleeding patterns. Hormone imbalances can arise from underlying health conditions such as:
- Polycystic ovary syndrome (PCOS)
- Insulin resistance
- Thyroid disorders
- Excess body weight
Puberty and the menopausal transition are both phases marked by significant hormonal fluctuations. Consequently, experiencing irregular or prolonged periods is quite common during these stages of reproductive life.
Blood-Thinning Medications
Blood thinners, also known as anticoagulants and antiplatelets, are prescribed to prevent blood clot formation. Anticoagulants, such as enoxaparin (Lovenox), work by slowing down the body’s natural clotting processes. It’s estimated that approximately 70% of women taking oral anticoagulants experience heavy menstrual bleeding. Antiplatelets, like aspirin, reduce platelet stickiness, thereby inhibiting clot formation.
While these medications are crucial for preventing vascular blockages and strokes, a potential side effect is heavy and prolonged menstrual bleeding.
Uterine Fibroids or Polyps
Fibroids are non-cancerous growths that develop from the muscular and connective tissues of the uterine wall. They can cause both pain and heavy menstrual bleeding because they interfere with the uterus’s ability to contract effectively, which is what causes menstrual cramps. Fibroids vary greatly in size, ranging from as small as an apple seed to as large as a grapefruit, or even bigger in some cases.
Polyps are also growths, but they attach to the inner lining of the uterus, the endometrium, by a stalk. Composed of endometrial tissue, polyps can also lead to irregular or heavy periods.
Adenomyosis
In typical uterine anatomy, endometrial tissue lines the uterus’s interior. In adenomyosis, endometrial-like tissue grows into the muscular wall of the uterus, causing thickening. This misplaced endometrial tissue behaves like normal endometrial tissue, shedding during your period. This results in heavier and often more painful periods.
Research indicates that among women experiencing adenomyosis symptoms, a significant percentage, ranging from 20% to 88.8%, report heavy and painful periods. The average age at diagnosis is typically between 32 and 38 years. Diagnosing adenomyosis can be complex due to the absence of standardized diagnostic criteria.
Thyroid Conditions
The thyroid gland, located at the base of your neck, produces thyroid hormone. It’s estimated that 1 in 8 women will experience a thyroid issue during their lifetime. Beyond regulating metabolism, the thyroid gland also plays a role in menstrual cycle regulation. An overactive or underactive thyroid can disrupt your menstrual cycle, leading to periods that are heavier or lighter than usual, or causing irregularities in cycle length and bleeding patterns.
Bleeding Disorders
Normal blood clotting, which occurs after an injury, is a complex process involving platelets and clotting factors. If your blood doesn’t clot effectively, either due to insufficient platelets or clotting factors, it can result in prolonged and/or heavy periods.
The most prevalent bleeding disorder affecting women is Von Willebrand disease (VWD). While VWD can affect both sexes, women often experience more pronounced symptoms due to its impact on menstruation. Bleeding disorders are frequently inherited, meaning they have a familial component.
Obesity
A higher body weight can impact the balance of reproductive hormones, potentially causing alterations in your menstrual cycle.
A 2021 study published in the Journal of Endocrinology found a correlation between higher body weight and heavy menstrual bleeding. This is thought to be linked to increased inflammation in the uterine lining, which can impair tissue repair after menstruation.
Pelvic Inflammatory Disease (PID)
Pelvic inflammatory disease (PID) is an infection of the upper female reproductive tract. It occurs when bacteria, often transmitted sexually, ascend from the vagina to the uterus, fallopian tubes, ovaries, and pelvis. PID can sometimes be asymptomatic until it manifests as fertility problems or persistent pelvic pain. However, it can also disrupt menstrual cycle regularity.
Cancer
Certain cancers, particularly those affecting the reproductive organs, can cause heavy or prolonged periods. Heavy bleeding can be an indicator of endometrial cancer. While endometrial cancer is more common in women in their mid-60s and beyond who have gone through menopause, women who experience irregular ovulation (such as those with PCOS) and women with obesity are at an increased risk. Endometrial hyperplasia, a precursor to endometrial cancer, can also manifest as irregular or heavy bleeding.
When Should You Seek Medical Advice?
It’s important to be aware of when changes in your period warrant medical attention. Consult your doctor if you experience any of the following:
- Menstrual bleeding lasting longer than 7 days
- Passing blood clots larger than a quarter
- Needing to change pads or tampons more frequently than every hour
- Requiring pad or tampon changes during the night
- Experiencing increased fatigue or lightheadedness
If you suspect your period is lasting longer than usual or you are experiencing heavy bleeding, don’t hesitate to reach out to your healthcare provider. Identifying the underlying cause of prolonged or heavy periods is crucial, both to rule out any serious medical conditions and to enhance your overall well-being and quality of life.
