Why Is My Period Not Ending: Understanding Prolonged Menstrual Bleeding

Have you been wondering, “Why Is My Period Not Ending?” Prolonged menstrual bleeding can be concerning, and it’s essential to understand the possible causes and what to do about it. At WHY.EDU.VN, we provide expert-backed information to help you navigate women’s health issues. This article explores the reasons behind an extended period, offering insights into potential underlying conditions and guidance on seeking appropriate medical advice. By understanding the factors that can affect your menstrual cycle, you can take proactive steps to manage your health.

1. What Defines a Period That Won’t End?

A period that won’t end, clinically known as menorrhagia or prolonged menstrual bleeding, is defined as menstrual bleeding that lasts longer than seven days or involves abnormally heavy bleeding. This condition can disrupt daily life and may indicate underlying health issues. Recognizing the symptoms and understanding when to seek medical help are crucial for managing this condition effectively.

Key Characteristics of Prolonged Menstrual Bleeding:

• Bleeding lasting more than seven days.
• Soaking through one or more sanitary pads or tampons every hour for several consecutive hours.
• Needing to use double sanitary protection to control menstrual flow.
• Passing large blood clots.
• Bleeding heavy enough to interfere with your daily activities.
• Symptoms of anemia, such as fatigue, weakness, or shortness of breath.

Why It’s Important to Address Prolonged Bleeding

Prolonged menstrual bleeding can lead to several complications if left unaddressed:

• Anemia: Heavy and prolonged bleeding can deplete iron stores in the body, leading to iron deficiency anemia.
• Pain: Severe menstrual bleeding can be accompanied by painful cramps, impacting quality of life.
• Emotional Distress: The inconvenience and anxiety associated with prolonged bleeding can cause emotional distress and affect mental well-being.
• Underlying Conditions: Prolonged bleeding can be a symptom of underlying health conditions, such as hormonal imbalances, uterine fibroids, or bleeding disorders, which require proper diagnosis and treatment.

When to Seek Medical Help

It is important to seek medical help if you experience any of the following:

• Your period lasts longer than seven days.
• You are soaking through sanitary pads or tampons every hour for several consecutive hours.
• You are passing large blood clots.
• You experience symptoms of anemia, such as fatigue, weakness, or shortness of breath.
• Your bleeding is interfering with your daily activities.

2. What Are Common Causes of a Period Not Ending?

There are several potential reasons why your period might not be ending. These range from hormonal imbalances to structural issues in the uterus. Identifying the root cause is essential for effective treatment. Here are some of the most common factors contributing to prolonged menstrual bleeding:

2.1. Hormonal Imbalances

Hormonal imbalances, particularly involving estrogen and progesterone, can significantly affect menstrual bleeding. These imbalances can disrupt the normal shedding of the uterine lining, leading to prolonged or heavy periods.

Conditions Related to Hormonal Imbalance:

• Polycystic Ovary Syndrome (PCOS): PCOS is a common endocrine disorder that affects women of reproductive age. It is characterized by irregular periods, excess androgens (male hormones), and/or polycystic ovaries. The hormonal imbalances in PCOS can lead to infrequent ovulation or no ovulation at all, resulting in irregular and prolonged bleeding.
• Thyroid Disorders: Both hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) can affect menstrual cycles. Thyroid hormones play a crucial role in regulating the menstrual cycle, and imbalances can cause irregular periods, including prolonged bleeding.
• Perimenopause: As women approach menopause, hormonal fluctuations become more common. Estrogen levels can fluctuate erratically during perimenopause, leading to changes in menstrual patterns, including longer and heavier periods.

How Hormonal Imbalances Affect Menstrual Bleeding:

• Estrogen Dominance: An excess of estrogen relative to progesterone can cause the uterine lining to thicken excessively. When the body eventually sheds this thicker lining, it can result in heavier and longer periods.
• Progesterone Deficiency: Progesterone helps regulate the menstrual cycle and ensures the uterine lining sheds properly. Insufficient progesterone can lead to an unstable uterine lining, causing irregular and prolonged bleeding.

2.2. Uterine Fibroids

Uterine fibroids are non-cancerous growths that develop in the uterus. They can vary in size and location, and their presence can significantly impact menstrual bleeding.

How Fibroids Cause Prolonged Bleeding:

• Distortion of the Uterine Cavity: Fibroids can distort the shape of the uterus, increasing the surface area of the uterine lining. This larger surface area results in more bleeding during menstruation, leading to heavier and longer periods.
• Interference with Uterine Contractions: Fibroids can interfere with the uterus’s ability to contract effectively. Uterine contractions help control bleeding by compressing blood vessels. When contractions are impaired, bleeding can be prolonged and heavier.
• Increased Blood Vessel Size: Fibroids can cause an increase in the size and number of blood vessels in the uterine lining. This can lead to greater blood flow during menstruation, resulting in heavier bleeding.

Symptoms of Uterine Fibroids:

• Prolonged menstrual periods (lasting more than seven days)
• Heavy menstrual bleeding (menorrhagia)
• Pelvic pain or pressure
• Frequent urination
• Constipation
• Back pain

2.3. Uterine Polyps

Uterine polyps are growths that develop in the lining of the uterus (endometrium). They are usually benign but can cause abnormal bleeding.

How Polyps Cause Prolonged Bleeding:

• Increased Surface Area: Polyps increase the surface area of the uterine lining, leading to more bleeding during menstruation.
• Irregular Shedding: Polyps can cause irregular shedding of the uterine lining, resulting in prolonged and unpredictable bleeding.
• Inflammation and Vascularity: Polyps can be highly vascular and prone to inflammation, which can contribute to increased bleeding.

Symptoms of Uterine Polyps:

• Irregular menstrual periods
• Prolonged menstrual bleeding
• Heavy menstrual bleeding
• Bleeding between periods
• Bleeding after menopause

2.4. Adenomyosis

Adenomyosis occurs when the endometrial tissue, which normally lines the uterus, grows into the muscular wall of the uterus (myometrium). This condition can cause the uterus to enlarge and lead to painful and heavy periods.

How Adenomyosis Causes Prolonged Bleeding:

• Enlarged Uterus: The presence of endometrial tissue within the uterine wall causes the uterus to enlarge, increasing the surface area of the uterine lining. This leads to heavier and longer periods.
• Impaired Uterine Contractions: Adenomyosis can disrupt the normal contractions of the uterus, which are essential for controlling bleeding during menstruation.
• Inflammation and Vascularity: The presence of endometrial tissue in the uterine wall can cause inflammation and increased vascularity, contributing to heavier bleeding.

Symptoms of Adenomyosis:

• Heavy menstrual bleeding
• Prolonged menstrual periods
• Severe menstrual cramps
• Pelvic pain
• Painful intercourse
• Enlarged uterus

2.5. Intrauterine Devices (IUDs)

Intrauterine devices (IUDs) are a form of contraception inserted into the uterus. While IUDs are generally safe and effective, they can sometimes cause changes in menstrual bleeding patterns.

Hormonal IUDs:

• Hormonal IUDs release progestin, a synthetic form of progesterone. Progestin thins the uterine lining and prevents pregnancy. However, in the first few months after insertion, hormonal IUDs can cause irregular bleeding, including spotting between periods and prolonged menstrual bleeding. Over time, the bleeding usually becomes lighter and more predictable.

Copper IUDs:

• Copper IUDs do not contain hormones. Instead, they prevent pregnancy by releasing copper ions, which are toxic to sperm. Copper IUDs can cause heavier and longer periods, especially in the first few months after insertion. The copper can irritate the uterine lining, leading to increased bleeding.

Symptoms Related to IUDs:

• Irregular menstrual periods
• Prolonged menstrual bleeding
• Heavy menstrual bleeding
• Spotting between periods
• Pelvic pain

2.6. Bleeding Disorders

Bleeding disorders are conditions that affect the blood’s ability to clot properly. These disorders can cause prolonged and heavy bleeding, including during menstruation.

Common Bleeding Disorders:

• Von Willebrand Disease (VWD): VWD is the most common inherited bleeding disorder. It is caused by a deficiency or dysfunction of von Willebrand factor (VWF), a protein that helps blood clot.
• Hemophilia: Hemophilia is a rare inherited bleeding disorder that primarily affects males. It is caused by a deficiency in clotting factors, proteins necessary for blood clotting.
• Platelet Disorders: Platelets are blood cells that help form blood clots. Disorders that affect the number or function of platelets can lead to bleeding problems.

How Bleeding Disorders Cause Prolonged Bleeding:

• Impaired Clotting: Bleeding disorders impair the body’s ability to form blood clots effectively. This can result in prolonged and heavy bleeding, including during menstruation.
• Increased Bleeding Time: Individuals with bleeding disorders may experience a longer bleeding time, meaning it takes longer for bleeding to stop.

Symptoms of Bleeding Disorders:

• Prolonged menstrual bleeding
• Heavy menstrual bleeding
• Easy bruising
• Frequent nosebleeds
• Prolonged bleeding after cuts or surgery
• Bleeding gums

2.7. Medications

Certain medications can affect menstrual bleeding patterns, leading to prolonged or heavy periods. It is important to be aware of these potential side effects and discuss them with your healthcare provider.

Common Medications That Can Affect Menstrual Bleeding:

• Anticoagulants (Blood Thinners): Medications like warfarin, heparin, and aspirin can thin the blood and interfere with clotting, leading to heavier and longer periods.
• Anti-inflammatory Drugs (NSAIDs): Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, can sometimes increase menstrual bleeding, although they are more commonly used to reduce menstrual pain.
• Hormonal Medications: Hormone-containing medications, such as birth control pills, hormone replacement therapy (HRT), and certain psychiatric medications, can disrupt the menstrual cycle and cause irregular bleeding.

2.8. Cancer

In rare cases, prolonged menstrual bleeding can be a sign of cancer, such as uterine cancer, cervical cancer, or endometrial cancer. It is essential to rule out cancer as a potential cause, especially in women who are postmenopausal or have other risk factors.

Uterine Cancer:

• Uterine cancer, also known as endometrial cancer, begins in the lining of the uterus. It is most common in women after menopause.

Cervical Cancer:

• Cervical cancer starts in the cells lining the cervix, the lower part of the uterus that connects to the vagina. It is often caused by human papillomavirus (HPV) infection.

Symptoms of Gynecological Cancers:

• Abnormal vaginal bleeding, including prolonged or heavy menstrual bleeding
• Bleeding between periods
• Bleeding after menopause
• Pelvic pain
• Painful intercourse
• Vaginal discharge

2.9. Ectopic Pregnancy

Ectopic pregnancy occurs when a fertilized egg implants outside the uterus, usually in the fallopian tube. This condition can cause abnormal bleeding and requires immediate medical attention.

Symptoms of Ectopic Pregnancy:

• Abnormal vaginal bleeding
• Pelvic pain
• Abdominal pain
• Dizziness
• Fainting

2.10. Miscarriage

Miscarriage, also known as spontaneous abortion, is the loss of a pregnancy before the 20th week of gestation. It can cause heavy and prolonged bleeding.

Symptoms of Miscarriage:

• Vaginal bleeding
• Pelvic pain
• Cramping
• Passage of tissue or clots

Understanding these potential causes is the first step in addressing the issue of a period that won’t end. Always consult with a healthcare provider for a thorough evaluation and appropriate treatment plan. At WHY.EDU.VN, we aim to provide comprehensive information to empower you to make informed decisions about your health.

3. What Are the Risk Factors for a Period That Won’t End?

Several factors can increase the likelihood of experiencing prolonged menstrual bleeding. Being aware of these risk factors can help you understand your individual risk and take proactive steps to manage your menstrual health. Here are some of the key risk factors associated with a period that won’t end:

3.1. Age

Age plays a significant role in the likelihood of experiencing prolonged menstrual bleeding. Both adolescents and women approaching menopause are at a higher risk due to hormonal fluctuations.

Adolescence:

• Hormonal Immaturity: In the years following the start of menstruation (menarche), the hormonal system is still developing. The ovaries may not release an egg (ovulate) regularly, leading to hormonal imbalances.
• Irregular Cycles: Irregular ovulation can result in an imbalance of estrogen and progesterone, causing the uterine lining to build up excessively. When this thickened lining sheds, it can lead to prolonged and heavy bleeding.
• Lack of Ovulation: Without regular ovulation, the body may not produce enough progesterone to regulate the menstrual cycle effectively. This can result in unpredictable and prolonged periods.

Perimenopause:

• Hormonal Fluctuations: As women approach menopause, hormone levels fluctuate dramatically. Estrogen levels can rise and fall erratically, leading to changes in menstrual patterns.
• Anovulation: Like in adolescence, women in perimenopause may experience cycles where they do not ovulate. This can cause the uterine lining to thicken without the regulatory effects of progesterone.
• Uterine Changes: The risk of developing uterine fibroids, polyps, and other structural abnormalities increases with age, contributing to prolonged and heavy bleeding.

3.2. Hormonal Imbalances

As previously mentioned, hormonal imbalances are a significant cause of prolonged menstrual bleeding. Conditions such as PCOS, thyroid disorders, and estrogen dominance can disrupt the normal menstrual cycle.

Polycystic Ovary Syndrome (PCOS):

• Irregular Ovulation: PCOS is characterized by irregular ovulation or a complete lack of ovulation. This can lead to an imbalance of hormones, causing the uterine lining to build up and shed irregularly.
• Elevated Androgens: High levels of androgens (male hormones) in women with PCOS can also interfere with the menstrual cycle.

Thyroid Disorders:

• Thyroid Hormone Imbalance: Both hypothyroidism and hyperthyroidism can affect the menstrual cycle. Thyroid hormones play a crucial role in regulating the menstrual cycle, and imbalances can cause irregular and prolonged bleeding.
• Impact on Ovulation: Thyroid disorders can also impact ovulation, leading to irregular periods.

3.3. Uterine Abnormalities

Structural abnormalities in the uterus, such as fibroids, polyps, and adenomyosis, are significant risk factors for prolonged menstrual bleeding.

Uterine Fibroids:

• Distortion of the Uterine Cavity: Fibroids can distort the shape of the uterus, increasing the surface area of the uterine lining. This larger surface area results in more bleeding during menstruation.
• Impaired Uterine Contractions: Fibroids can interfere with the uterus’s ability to contract effectively. Uterine contractions help control bleeding by compressing blood vessels. When contractions are impaired, bleeding can be prolonged and heavier.

Uterine Polyps:

• Increased Surface Area: Polyps increase the surface area of the uterine lining, leading to more bleeding during menstruation.
• Irregular Shedding: Polyps can cause irregular shedding of the uterine lining, resulting in prolonged and unpredictable bleeding.

Adenomyosis:

• Enlarged Uterus: The presence of endometrial tissue within the uterine wall causes the uterus to enlarge, increasing the surface area of the uterine lining. This leads to heavier and longer periods.
• Impaired Uterine Contractions: Adenomyosis can disrupt the normal contractions of the uterus, which are essential for controlling bleeding during menstruation.

3.4. Use of Intrauterine Devices (IUDs)

The type of IUD used can influence the risk of prolonged menstrual bleeding. Copper IUDs are more likely to cause heavier and longer periods compared to hormonal IUDs, especially in the initial months after insertion.

Copper IUDs:

• Inflammation: Copper IUDs can cause inflammation of the uterine lining, leading to increased bleeding.
• Lack of Hormones: Because copper IUDs do not contain hormones, they do not thin the uterine lining like hormonal IUDs do. This can result in heavier and longer periods.

Hormonal IUDs:

• Irregular Bleeding: In the first few months after insertion, hormonal IUDs can cause irregular bleeding, including spotting between periods and prolonged menstrual bleeding. However, over time, the bleeding usually becomes lighter and more predictable.

3.5. Bleeding Disorders

Individuals with bleeding disorders are at a higher risk of experiencing prolonged menstrual bleeding due to impaired blood clotting.

Von Willebrand Disease (VWD):

• VWF Deficiency: VWD is caused by a deficiency or dysfunction of von Willebrand factor (VWF), a protein that helps blood clot. This can lead to prolonged and heavy bleeding, including during menstruation.

Hemophilia:

• Clotting Factor Deficiency: Hemophilia is caused by a deficiency in clotting factors, proteins necessary for blood clotting. This can result in prolonged bleeding.

Platelet Disorders:

• Platelet Dysfunction: Disorders that affect the number or function of platelets can lead to bleeding problems.

3.6. Obesity

Obesity can affect hormone levels and increase the risk of prolonged menstrual bleeding. Fat tissue produces estrogen, and excess body fat can lead to higher estrogen levels.

Hormonal Effects:

• Increased Estrogen: Higher estrogen levels can cause the uterine lining to thicken excessively, leading to heavier and longer periods.
• Insulin Resistance: Obesity is often associated with insulin resistance, which can disrupt hormone levels and contribute to menstrual irregularities.

3.7. Family History

A family history of bleeding disorders, uterine fibroids, or hormonal imbalances can increase your risk of experiencing prolonged menstrual bleeding.

Genetic Predisposition:

• Bleeding Disorders: Inherited bleeding disorders like VWD and hemophilia can run in families.
• Uterine Fibroids: Women with a family history of uterine fibroids are more likely to develop them themselves.
• Hormonal Imbalances: A predisposition to hormonal imbalances can also be inherited.

3.8. Certain Medications

As mentioned earlier, certain medications, such as anticoagulants and anti-inflammatory drugs, can increase the risk of prolonged menstrual bleeding.

Anticoagulants:

• Blood Thinning: Medications like warfarin and heparin thin the blood and interfere with clotting, leading to heavier and longer periods.

Anti-inflammatory Drugs:

• NSAIDs: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, can sometimes increase menstrual bleeding.

By understanding these risk factors, you can take proactive steps to manage your menstrual health and seek timely medical advice if you experience prolonged menstrual bleeding. At WHY.EDU.VN, we are committed to providing comprehensive information to empower you to make informed decisions about your health.

4. How Is a Period That Won’t End Diagnosed?

Diagnosing the cause of a period that won’t end typically involves a combination of medical history review, physical examination, and diagnostic tests. The goal is to identify any underlying conditions contributing to the prolonged bleeding and to develop an appropriate treatment plan. Here are the common steps involved in diagnosing the cause of prolonged menstrual bleeding:

4.1. Medical History Review

The healthcare provider will start by taking a detailed medical history, including questions about:

• Menstrual History:
  • Age of menarche (first period)
  • Length of menstrual cycles
  • Duration and heaviness of menstrual flow
  • Any changes in menstrual patterns
• Medical Conditions:
  • Any known medical conditions, such as PCOS, thyroid disorders, or bleeding disorders
  • Past surgeries or medical procedures
• Medications:
  • Current medications, including prescription drugs, over-the-counter medications, and supplements
• Family History:
  • Family history of bleeding disorders, uterine fibroids, or hormonal imbalances
• Lifestyle Factors:
  • Diet, exercise habits, and stress levels

4.2. Physical Examination

A physical examination is an essential part of the diagnostic process. It may include:

• General Assessment: Checking vital signs, such as blood pressure and heart rate, and assessing overall health.
• Pelvic Examination: A pelvic exam allows the healthcare provider to evaluate the reproductive organs, including the uterus, ovaries, and cervix. This may involve:
  • Visual Inspection: Examining the external genitalia and vaginal area for any abnormalities.
  • Speculum Examination: Using a speculum to visualize the cervix and vaginal walls.
  • Bimanual Examination: Inserting two gloved fingers into the vagina while placing the other hand on the abdomen to feel the size, shape, and position of the uterus and ovaries.

4.3. Blood Tests

Blood tests can help identify hormonal imbalances, anemia, and bleeding disorders. Common blood tests include:

• Complete Blood Count (CBC):
  • Measures the number of red blood cells, white blood cells, and platelets.
  • Helps detect anemia, infection, or other blood disorders.
• Hormone Levels:
  • Follicle-Stimulating Hormone (FSH): Assesses ovarian function.
  • Luteinizing Hormone (LH): Assesses ovulation.
  • Estrogen: Measures estrogen levels.
  • Progesterone: Measures progesterone levels.
  • Thyroid-Stimulating Hormone (TSH): Assesses thyroid function.
• Iron Studies:
  • Serum Iron: Measures the amount of iron in the blood.
  • Ferritin: Measures iron stores in the body.
  • Helps diagnose iron deficiency anemia.
• Coagulation Studies:
  • Prothrombin Time (PT): Assesses blood clotting time.
  • Partial Thromboplastin Time (PTT): Assesses blood clotting time.
  • Von Willebrand Factor (VWF) Assay: Measures VWF levels and function.
  • Helps diagnose bleeding disorders.

4.4. Imaging Studies

Imaging studies can provide detailed views of the uterus, ovaries, and other pelvic organs. Common imaging studies include:

• Ultrasound:
  • Transvaginal Ultrasound: A probe is inserted into the vagina to obtain detailed images of the uterus and ovaries.
  • Abdominal Ultrasound: A transducer is placed on the abdomen to visualize the pelvic organs.
  • Helps detect uterine fibroids, polyps, adenomyosis, and ovarian cysts.
• Hysterosonography:
  • Involves injecting saline solution into the uterus through a catheter while performing a transvaginal ultrasound.
  • Helps visualize the uterine lining and detect polyps or other abnormalities.
• Magnetic Resonance Imaging (MRI):
  • Uses magnetic fields and radio waves to create detailed images of the pelvic organs.
  • Provides more detailed information about uterine fibroids, adenomyosis, and other structural abnormalities.

4.5. Endometrial Biopsy

An endometrial biopsy involves taking a small sample of the uterine lining (endometrium) for examination under a microscope. This can help detect abnormal cells, such as those found in endometrial hyperplasia or cancer.

Procedure:

• A thin, flexible tube is inserted through the cervix into the uterus.
• A small sample of the endometrial tissue is collected.
• The tissue sample is sent to a laboratory for analysis.

4.6. Hysteroscopy

Hysteroscopy involves inserting a thin, lighted scope (hysteroscope) through the cervix into the uterus to visualize the uterine cavity. This allows the healthcare provider to examine the uterine lining and identify any abnormalities, such as polyps or fibroids.

Procedure:

• The hysteroscope is inserted through the cervix into the uterus.
• The uterine cavity is filled with saline solution or carbon dioxide to expand it and improve visualization.
• The healthcare provider examines the uterine lining for any abnormalities.
• If necessary, a biopsy can be taken, or polyps or small fibroids can be removed during the procedure.

4.7. Dilation and Curettage (D&C)

Dilation and curettage (D&C) is a surgical procedure that involves dilating the cervix and scraping the uterine lining with a special instrument called a curette. This procedure is used to diagnose and treat abnormal bleeding.

Procedure:

• The cervix is dilated with medication or instruments.
• A curette is inserted into the uterus to scrape the uterine lining.
• The tissue sample is sent to a laboratory for analysis.

After a thorough evaluation and diagnostic testing, the healthcare provider can determine the underlying cause of the prolonged menstrual bleeding and develop an appropriate treatment plan. At WHY.EDU.VN, we emphasize the importance of seeking professional medical advice for accurate diagnosis and effective management of menstrual health issues.

5. What Are the Treatment Options for a Period That Won’t End?

The treatment options for a period that won’t end depend on the underlying cause of the prolonged bleeding, as well as the individual’s overall health, age, and desire for future fertility. Treatment may include medical therapies, surgical procedures, or a combination of both. Here are the common treatment options for managing prolonged menstrual bleeding:

5.1. Medical Therapies

Medical therapies aim to control bleeding and address hormonal imbalances or other underlying conditions.

5.1.1. Hormonal Birth Control

Hormonal birth control methods, such as birth control pills, patches, or vaginal rings, can help regulate the menstrual cycle and reduce bleeding.

• How They Work:
  • Hormonal birth control contains synthetic estrogen and/or progestin, which help stabilize hormone levels and prevent the uterine lining from building up excessively.
  • They can also reduce the production of prostaglandins, substances that contribute to menstrual pain and heavy bleeding.
• Benefits:
  • Reduce menstrual bleeding and pain
  • Regulate menstrual cycles
  • Provide contraception
• Considerations:
  • May cause side effects, such as mood changes, weight gain, or breast tenderness
  • Not suitable for women with certain medical conditions, such as a history of blood clots or certain types of cancer

5.1.2. Progestin Therapy

Progestin therapy involves taking synthetic progesterone to help regulate the menstrual cycle and reduce bleeding.

• How It Works:
  • Progestin helps stabilize the uterine lining and ensures it sheds properly.
  • It can also counteract the effects of excess estrogen, which can contribute to heavy bleeding.
• Benefits:
  • Reduce menstrual bleeding
  • Regulate menstrual cycles
  • Can be taken orally or administered via an intrauterine device (IUD)
• Considerations:
  • May cause side effects, such as bloating, breast tenderness, or mood changes

5.1.3. Tranexamic Acid

Tranexamic acid is a non-hormonal medication that helps reduce menstrual bleeding by promoting blood clotting.

• How It Works:
  • Tranexamic acid inhibits the breakdown of blood clots, helping to reduce bleeding.
• Benefits:
  • Reduces menstrual bleeding without affecting hormone levels
  • Can be taken only during menstruation
• Considerations:
  • May cause side effects, such as nausea, diarrhea, or dizziness
  • Not suitable for women with a history of blood clots

5.1.4. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs, such as ibuprofen and naproxen, can help reduce menstrual pain and bleeding by reducing the production of prostaglandins.

• How They Work:
  • NSAIDs inhibit the production of prostaglandins, substances that contribute to menstrual pain and heavy bleeding.
• Benefits:
  • Reduce menstrual pain and bleeding
  • Available over-the-counter
• Considerations:
  • May cause side effects, such as stomach upset, heartburn, or ulcers
  • Should be taken with food to minimize stomach irritation

5.1.5. Iron Supplements

Iron supplements can help treat iron deficiency anemia, a common complication of prolonged menstrual bleeding.

• How They Work:
  • Iron supplements replenish iron stores in the body, helping to improve red blood cell production and reduce symptoms of anemia.
• Benefits:
  • Treat iron deficiency anemia
  • Improve energy levels and reduce fatigue
• Considerations:
  • May cause side effects, such as constipation, nausea, or stomach upset
  • Should be taken with food to improve absorption and minimize stomach irritation

5.2. Surgical Procedures

Surgical procedures may be necessary to treat structural abnormalities in the uterus, such as fibroids, polyps, or adenomyosis.

5.2.1. Hysteroscopy with Polypectomy or Myomectomy

Hysteroscopy involves inserting a thin, lighted scope through the cervix into the uterus to visualize the uterine cavity. During hysteroscopy, polyps (polypectomy) or small fibroids (myomectomy) can be removed.

• How It Works:
  • The hysteroscope allows the surgeon to visualize the uterine lining and identify polyps or fibroids.
  • Specialized instruments are used to remove the polyps or fibroids.
• Benefits:
  • Minimally invasive procedure
  • Can be performed on an outpatient basis
  • Preserves fertility
• Considerations:
  • May require anesthesia
  • Risk of complications, such as bleeding or infection

5.2.2. Endometrial Ablation

Endometrial ablation involves destroying the lining of the uterus (endometrium) to reduce or eliminate menstrual bleeding.

• How It Works:
  • Various techniques can be used to destroy the endometrium, including heat, radiofrequency energy, or freezing.
  • After endometrial ablation, the uterine lining no longer sheds during menstruation, resulting in reduced or absent periods.
• Benefits:
  • Reduces or eliminates menstrual bleeding
  • Minimally invasive procedure
  • Can be performed on an outpatient basis
• Considerations:
  • Not suitable for women who desire future fertility
  • Risk of complications, such as bleeding, infection, or uterine perforation

5.2.3. Uterine Artery Embolization (UAE)

Uterine artery embolization (UAE) is a minimally invasive procedure used to treat uterine fibroids. It involves blocking the blood supply to the fibroids, causing them to shrink.

• How It Works:
  • A catheter is inserted into an artery in the groin and guided to the uterine arteries.
  • Small particles are injected into the uterine arteries to block blood flow to the fibroids.
  • The fibroids shrink due to lack of blood supply.
• Benefits:
  • Minimally invasive procedure
  • Preserves the uterus
  • Can reduce fibroid-related symptoms, such as heavy bleeding and pelvic pain
• Considerations:
  • May cause post-embolization syndrome, characterized by pain, fever, and nausea
  • Not suitable for women who desire future fertility

5.2.4. Myomectomy

Myomectomy is a surgical procedure to remove uterine fibroids while preserving the uterus. It can be performed through various approaches, including:

• Abdominal Myomectomy:
  • Involves making an incision in the abdomen to access the uterus and remove the fibroids.
  • Suitable for large or multiple fibroids.
• Laparoscopic Myomectomy:
  • Involves making small incisions in the abdomen and using a laparoscope (a thin, lighted scope) to visualize the uterus and remove the fibroids.
  • Less invasive than abdominal myomectomy, with a shorter recovery time.
• Hysteroscopic Myomectomy:
  • Involves inserting a hysteroscope through the cervix into the uterus to remove fibroids that are located within the uterine cavity.
• Benefits:
  • Preserves the uterus
  • Can improve fibroid-related symptoms, such as heavy bleeding and pelvic pain
• Considerations:
  • May require anesthesia
  • Risk of complications, such as bleeding, infection, or uterine scarring

5.2.5. Hysterectomy

Hysterectomy is the surgical removal of the uterus. It is a definitive treatment for prolonged menstrual bleeding and is typically considered when other treatments have failed or are not appropriate.

• How It Works:
  • The uterus is surgically removed through an abdominal incision, a vaginal incision, or laparoscopically.
  • Depending on the situation, the ovaries and fallopian tubes may also be removed.
• Benefits:
  • Eliminates menstrual bleeding
  • Provides definitive treatment for uterine abnormalities
• Considerations:
  • Major surgical procedure with a longer recovery time
  • Not suitable for women who desire future fertility
  • May cause hormonal changes if the ovaries are removed

The choice of treatment depends on various factors, including the underlying cause of the prolonged bleeding, the individual’s overall health, age, and desire for future fertility. It is important to discuss the risks and benefits of each treatment option with your healthcare provider to make an informed decision. At why.edu.vn, we encourage you to seek professional medical advice for accurate diagnosis and effective management of menstrual health issues.

6. Lifestyle Adjustments to Manage Prolonged Periods

In addition to medical treatments, certain lifestyle adjustments can help manage prolonged periods and improve overall well-being. These adjustments focus on diet, exercise, stress management, and other healthy habits. Here are some lifestyle changes that can be beneficial:

6.1. Diet Modifications

A balanced diet rich in essential nutrients can help manage prolonged periods and reduce symptoms like fatigue and anemia.

6.1.1. Iron-Rich Foods

• Why: Prolonged menstrual bleeding can lead to iron deficiency anemia. Consuming iron-rich foods helps replenish iron stores and improve red blood cell production.
• Foods to Include:
  • Lean meats (beef, poultry, fish)
  • Dark green leafy vegetables (spinach, kale)
  • Legumes (beans, lentils)