Can a period last for 2 weeks: Menorrhagia: Symptoms, Causes, Treatments
Menorrhagia: Symptoms, Causes, Treatments
What is menorrhagia?
Menorrhagia is a common disorder in women. Menorrhagia is the medical term for menstrual bleeding lasting for longer than 7 days. About 1 in every 20 women has menorrhagia.
Some of the bleeding can be very heavy, meaning you would change your tampon or pad after less than 2 hours. It can also mean you pass clots the size of a quarter or even larger.
Menorrhagia can lead to anemia if not treated. Also, the heavy bleeding can affect sleep, cause lower abdominal pain and make enjoyable activities a burden.
If you are experiencing weakness and a disruption to everyday life due to heavy bleeding, you should ask your doctor for treatment options.
Symptoms and Causes
What are the signs and symptoms of menorrhagia?
Signs of menorrhagia include:
- Soaking 1 or more tampons or pads every hour for many consecutive hours
- Doubling up on pads
- Changing pads or tampons during the night
- Long-lasting menstrual periods (longer than 7 days)
- Blood clots the size of a quarter or larger
- Bleeding that is keeping you from doing normal activities
- Constant pain in lower part of stomach
- Lacking energy
- Shortness of breath
What causes menorrhagia?
Menorrhagia can be caused by uterine problems, hormone problems or other illnesses. Other causes include:
- Growths or tumors of the uterus that are not cancer
- Cancer of the cervix or uterus
- Particular types of birth control
- Pregnancy-related problems (miscarriage or ectopic pregnancy, when the fertilized egg implants outside the uterus)
- Bleeding disorders
- Liver, kidney or thyroid disease
- Pelvic inflammatory disease (and infection of the female reproductive organs)
- Taking certain drugs, such as aspirin
- The menopause transition, also referred to as perimenopause
- Fibroids or polyps in the lining or muscle of the womb
Diagnosis and Tests
How is menorrhagia diagnosed?
Menorrhagia is diagnosed by your doctor through a series of questions about your medical history and menstrual cycles. Usually for women with menorrhagia bleeding lasts for more than 7 days and more blood is lost (80 milliliters compared to 60 milliliters).
Your doctor may ask for information about:
- Your age when you got your first period
- Length of your menstrual cycle
- Number of days your period lasts
- Number of days your period is heavy
- Quality of life during your period
- Family members with a history of heavy menstrual bleeding
- Stress you are facing
- Weight problems
- Current medications
Physical tests or exams done to diagnose menorrhagia may include:
- Pelvic exam
- Blood test to check thyroid, check for anemia and how the blood clots
- Pap test to check cells from cervix for changes
- Endometrial biopsy to check uterine tissue for cancer or abnormalities
- Ultrasound to check function of blood vessels, tissues and organs
Sometimes additional tests are still required to understand the cause of bleeding, including:
- Sonohysterogram to check for problems in the lining of the uterus
- Hysteroscopy to check for polyps, fibroids or other problems
- Dilation and curettage (“D&C”). This test can also treat the cause of the bleeding. During this test, the lining of the uterus is scraped and examined under sedation.
Management and Treatment
How is menorrhagia treated?
Treatment for menorrhagia depends on how serious the bleeding is, the cause of the bleeding, your health, age, and medical history. Also, treatment depends on your response to certain medicines and your wants and needs. You may not want to have a period at all, or just want to reduce the amount of bleeding. In addition, your decision to get pregnant or not will affect what treatment you choose. If you do not have anemia, you can choose to not have treatment.
Common treatments include:
- Iron supplements to put more iron into your blood
- Ibuprofen to reduce pain and amount of bleeding
- Birth control to make periods more regular and reduce bleeding (pills, vaginal ring, patch)
- Intrauterine contraception (IUD) to make periods more regular and reduce bleeding
- Hormone therapy to reduce bleeding
- Desmopressin nasal spray to stop bleeding for certain bleeding disorders
- Antifibrinolytic medicines to reduce bleeding
- Dilation and curettage to reduce bleeding by removing the top layer of uterus lining
- Operative hysteroscopy to remove fibroids and polyps and remove lining of uterus
- Endometrial ablation or resection to remove all or part of the lining of the uterus
- Hysterectomy to surgically remove the uterus and you will stop having your period
How is menorrhagia managed?
To manage menorrhagia, some women stay home on days when they are bleeding heavily. Others leave the house if they know a bathroom will be nearby. Also, it is a good practice to keep pads and/or tampons in your purse or at work. Wearing dark pants or skirts can help if you are worried about stains on light-colored clothing. Additionally, you can use a waterproof sheet on your mattress to prevent stains.
How is menorrhagia prevented?
Menorrhagia cannot be prevented. However, talking with your doctor to get diagnosed and treated can prevent other health issues in the future.
Outlook / Prognosis
What is the prognosis for living with menorrhagia?
If left untreated, menorrhagia can interfere with daily life. In addition, it can cause anemia and leave you feeling tired and weak. Other health problems can also arise if the bleeding problem is not resolved. With proper treatment and doctor assistance, menorrhagia can be managed and not cause a disruption to your life.
When do you call the doctor if you suspect menorrhagia?
You should call the doctor if you are passing clots the size of a quarter or larger. You should also call the doctor if you need to change your tampon or pad after less than 2 hours due to heavy bleeding.
Normal Menstrual Cycle | HealthLink BC
What is a menstrual cycle?
The menstrual cycle is the series of changes a woman’s body goes through to prepare for a pregnancy. About once a month, the uterus grows a new lining (endometrium) to get ready for a fertilized egg. When there is no fertilized egg to start a pregnancy, the uterus sheds its lining. This is the monthly menstrual bleeding (also called menstrual period) that women have from their early teen years until menopause, around age 50.
The menstrual cycle is from Day 1 of bleeding to Day 1 of the next time of bleeding. Although the average cycle is 28 days, it is normal to have a cycle that is shorter or longer.
Girls usually start having menstrual periods between the ages of 11 and 14. Women usually start to have fewer periods between ages 39 and 51. Women in their 40s and teens may have cycles that are longer or change a lot. If you are a teen, your cycles should even out with time. If you are nearing menopause, your cycles will probably get longer and then will stop.
Talk to your doctor if you notice any big change in your cycle. It’s especially important to check with your doctor if you have three or more menstrual periods that last longer than 7 days or are very heavy. Also call if you have bleeding between your periods or pelvic pain that is not from your period.
What controls the menstrual cycle?
Your hormones control your menstrual cycle. During each cycle, your brain’s hypothalamus and pituitary gland send hormone signals back and forth with your ovaries. These signals get the ovaries and uterus ready for a pregnancy.
The hormones estrogen and progesterone play the biggest roles in how the uterus changes during each cycle.
- Estrogen builds up the lining of the uterus.
- Progesterone increases after an ovary releases an egg (ovulation) at the middle of the cycle. This helps the estrogen keep the lining thick and ready for a fertilized egg.
- A drop in progesterone (along with estrogen) causes the lining to break down. This is when your period starts.
A change in hormone levels can affect your cycle or fertility. For example, teens tend to have low or changing progesterone levels. This is also true for women close to menopause. That is why teens and women in their 40s may have heavy menstrual bleeding and cycles that change in length.
Other things can change your cycle. They include birth control pills, low body fat, losing a lot of weight, or being overweight. Stress or very hard exercise also can change your cycle. Pregnancy is the most common cause of a missed period.
What common symptoms are linked to the menstrual cycle?
Some women have no pain or other problems. But other women have symptoms before and during their periods.
For about a week before a period, many women have some premenstrual symptoms. You may feel more tense or angry. You may gain water weight and feel bloated. Your breasts may feel tender. You may get acne. You also may have less energy than usual. A day or two before your period, you may start having pain (cramps) in your belly, back, or legs. These symptoms go away during the first days of a period.
When your ovary releases an egg in the middle of your cycle, you may have pain in your lower belly. You also might have red spotting for less than a day. Both are normal.
How can women take care of bleeding and symptoms?
You can use pads, tampons, or menstrual cups to manage bleeding. Be sure to change tampons at least every 4 to 8 hours. Pads or menstrual cups may be best at night.
Many women can improve their symptoms by getting regular exercise and eating a healthy diet. It also may help to limit alcohol and caffeine. Try to reduce stress.
A heating pad, hot water bottle, or warm bath also can help with cramps. You can take an over-the-counter medicine such as ibuprofen or naproxen before and during your period to reduce pain and bleeding.
Normal Menstrual Cycle
The menstrual cycle is the series of changes your body goes through to prepare for a possible pregnancy. About once a month, the uterus grows a new, thickened lining (endometrium) that can hold a fertilized egg. When there is no fertilized egg to start a pregnancy, the uterus then sheds its lining. This is the monthly menstrual bleeding (also called menstruation or menstrual period) that you have from your early teen years until your menstrual periods end around age 50 (menopause).
See a picture of a woman’s reproductive system.
The menstrual cycle is measured from the first day of menstrual bleeding, Day 1, up to Day 1 of your next menstrual bleeding. Although 28 days is the average cycle length, it is normal to have a cycle that is shorter or longer.
- A teen’s cycles may be long (up to 45 days), growing shorter over several years.
- Around ages 25 and 35, most women’s cycles are regular, generally lasting 21 to 35 days.
- Around ages 40 to 42, cycles tend to be the shortest and most regular. This is followed by 8 to 10 years of longer, less predictable cycles until menopause.
Three phases of the menstrual cycle
The phases of your menstrual cycle are triggered by hormonal changes.
On Day 1 of your cycle, the thickened lining (endometrium) of the uterus begins to shed. You know this as menstrual bleeding from the vagina. A normal menstrual period can last 4 to 6 days.
Most of your menstrual blood loss happens during the first 3 days. This is also when you might have cramping pain in your pelvis, legs, and back. Cramps can range from mild to severe. The cramping is your uterus contracting, helping the endometrium shed. In general, any premenstrual symptoms that you’ve felt before your period will go away during these first days of your cycle.
During the follicular phase, an egg follicle on an ovary gets ready to release an egg. Usually, one egg is released each cycle. This process can be short or long and plays the biggest role in how long your cycle is. At the same time, the uterus starts growing a new endometrium to prepare for pregnancy.
The last 5 days of the follicular phase, plus ovulation day, are your fertile window. This is when you are most likely to become pregnant if you have sex without using birth control.
Luteal (premenstrual) phase
This phase starts on ovulation day, the day the egg is released from the egg follicle on the ovary. It can happen any time from Day 7 to Day 22 of a normal menstrual cycle. During ovulation, some women have less than a day of red spotting or lower pelvic pain or discomfort (mittelschmerz). These signs of ovulation are normal.
- If the egg is fertilized by sperm and then implants in (attaches to) the endometrium, a pregnancy begins. (This pregnancy is dated from Day 1 of this menstrual cycle.)
- If the egg is not fertilized or does not implant, the endometrium begins to break down.
After the teen years and before perimenopause in your 40s, your luteal phase is very predictable. It normally lasts 13 to 15 days, from ovulation until menstrual bleeding starts a new cycle. This 2-week period is also called the “premenstrual” period.
Many women have premenstrual symptoms during all or part of the luteal phase. You may feel tense, angry, or emotional. You may gain water weight and feel bloated. Or you may have tender breasts or acne. A day or more before your period, you may start to have pain (cramps) in your abdomen, back, or legs. It is normal to have less energy at this time. Some women also have headaches, diarrhea or constipation, nausea, dizziness, or fainting.
When premenstrual symptoms make your daily life difficult, you are said to have premenstrual syndrome (PMS). For more information, see the topic Premenstrual Syndrome (PMS).
Menarche and the Teenage Menstrual Cycle
Menarche (say “MEN-ar-kee”) is a girl’s first menstrual period. A first period usually happens after breasts, pubic hair, and underarm hair have begun to grow. Menarche is a sign of growing up and becoming a woman. It can happen as early as about age 9 or up to age 15. The first few periods are usually light and irregular. About 2 out of 3 girls have a regular pattern of menstrual periods within 2 years of menarche.footnote 1 During the teen years, periods may become longer and heavier. For more information, see Menarche.
Perimenopausal Menstrual Cycle
Perimenopause, which means “around menopause,” refers to the 2 to 8 years of changing hormone levels and related symptoms that lead up to menopause. The most common sign of perimenopause is longer, often irregular menstrual cycles that are caused by hormonal ups and downs.
Most women start perimenopause between ages 39 and 51. Some women begin to notice menstrual changes and premenstrual syndrome (PMS) symptoms in their late 30s when hormones begin to fluctuate and fertility naturally declines. Other women don’t notice perimenopausal changes until their late 40s.
Perimenopause is a time of unpredictability. Menstrual and hormone-related symptoms are different for every woman. Some notice few or no changes. And others have severe symptoms that disrupt their sleep and daily lives. As during the teen years, irregular cycles can lead to heavy menstrual bleeding. Other common symptoms include mild to severe hot flashes, insomnia, cloudy thinking, headaches, heart palpitations, mood swings, irritability, depression, and anxiety. Some of these symptoms can also be related to aging and other life changes. See your doctor to discuss your symptoms, whether you want symptom treatment, and which therapies you can consider.
See a doctor for menstrual bleeding that lasts longer than 7 days or for cycles that are shorter than 21 days or longer than 35 days. For more information, see the topics Abnormal Uterine Bleeding and Menopause and Perimenopause.
Managing Menstrual Cycle Symptoms and Bleeding
Keep a calendar and mark the day you start your menstrual period each month. If your cycle is regular, it can help you predict when you’ll have your next period.
If you’re trying to figure out whether you have a pattern of premenstrual symptoms, it may be helpful to keep a premenstrual daily symptom diary .
You can improve your body’s ability to handle menstrual changes by getting regular exercise, eating a healthy diet, limiting alcohol and caffeine intake, and reducing stress. Non-prescription pain relievers can also help reduce some symptoms.
Medicine for menstrual pain and bleeding
Try a non-prescription medicine to help relieve your pain and bleeding. Start taking the recommended dose of pain reliever when symptoms begin or 1 day before your menstrual period starts. If you are trying to become pregnant, talk to your doctor before using any medicine. Be safe with medicines. Read and follow all instructions on the label.
- Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (for example, Advil), reduce menstrual cramps, pain, and bleeding by lowering the level of the hormone prostaglandin.
- If NSAIDs do not relieve the pain, try acetaminophen, such as Tylenol.
- Take the medicine for as long as the symptoms would normally last if you did not take the medicine.
Be sure to follow all labels and directions. Do not take aspirin if you are younger than 18 because of the risk of Reye syndrome.
Additional ways to relieve menstrual cramps
- Apply heat to your abdomen with a heating pad or hot water bottle, or take a warm bath. Heat improves blood flow and may decrease pelvic pain.
- Lie down and elevate your legs by putting a pillow under your knees.
- Lie on your side and bring your knees up toward your chest. This will help relieve back pressure.
- Get regular exercise. This improves blood flow, produces pain-fighting endorphins, and may reduce pain.
- If you have vaginal pain with cramps, try using pads instead of tampons.
For more information on managing menstrual cramps, see:
Managing menstrual bleeding
You can choose from a range of pads, tampons, or menstrual cups to manage menstrual bleeding. Follow all directions included with the product of your choice.
- Pads range from thin and light to thick and superabsorbent. They protect your clothing, with or without using a tampon. Pads may be your best choice for use at night.
- Tampons range from small to large, for light to heavy flow. You can place a tampon in the vagina by using a slender tube (that is packaged with the tampon) or by tucking it in with a finger. Be sure to change a tampon at least every 4 to 8 hours. This helps prevent leakage and infection.
- Menstrual cups are inserted in the vagina to collect menstrual flow. You remove the menstrual cup to empty it. Some are disposable and some can be washed and used again.
Whatever you use, be sure to change it regularly. Tampons and menstrual cups are ideal for activities that pads aren’t practical for, such as swimming. Tampons should be changed at least every 4 to 8 hours, so they may not work as well for nighttime use. Menstrual cups can be worn for up to 12 hours. It may take some experimenting to find the right products for you.
When to Call a Doctor
There is a broad range of “normal” among menstruating women. Unpredictable or long menstrual cycles are normal for teenagers and women in their 40s. For teens, a normal cycle can be as short as 21 days or as long as 45 daysfootnote 2. If you are a teen, you can expect cycles to even out over time. If you are nearing the age of menopause, you can expect menstrual cycles to become longer and eventually to stop. If you are not a teen and you are not older than 40 and your cycles are shorter than 21 days or longer than 35 days, there is a chance that you have a problem that needs to be checked by your doctor.
You will need a medical check by a doctor if you have any change in your menstrual pattern or amount of bleeding that affects your daily life. This includes menstrual bleeding, for three or more menstrual cycles, that:
- Lasts longer than 7 days.
- Is a sudden or big change from your usual period.
- Is very heavy. This means that you are passing large clots or soaking through your usual pads or tampons each hour for 2 or more hours.
Other symptoms you need to have checked include:
- Bleeding between menstrual periods.
- Pelvic pain that is not linked to menstrual bleeding and lasts longer than a day.
If you are a teenage girl, see your doctor if you have not started having periods by age 15.
For more information, see the topics Abnormal Vaginal Bleeding and Abnormal Uterine Bleeding.
- Hillard PJA (2012). Benign diseases of the female reproductive tract. In JS Berek, ed., Berek and Novak’s Gynecology, 15th ed., pp. 374–437. Philadelphia: Lippincott Williams and Wilkins.
- American Academy of Pediatrics, American College of Obstetricians and Gynecologists (2006, reaffirmed 2009). Menstruation in girls and adolescents: Using the menstrual cycle as a vital sign. Pediatrics, 118(5): 2245–2250.
Current as of:
November 8, 2019
Author: Healthwise Staff
Sarah Marshall MD – Family Medicine
Anne C. Poinier MD – Internal Medicine
Adam Husney MD – Family Medicine
Martin J. Gabica MD – Family Medicine
Kathleen Romito MD – Family Medicine
Femi Olatunbosun MB, FRCSC – Obstetrics and Gynecology
Rebecca Sue Uranga
Irregular periods – NHS
Irregular periods aren’t always a sign of a problem, but sometimes it’s a good idea to see a doctor about them just in case.
What are irregular periods?
You have irregular periods if the length of your menstrual cycle (the gap between your periods starting) keeps changing.
Your periods may come early or late.
The average menstrual cycle lasts 28 days, although it’s normal for it to be a bit shorter or longer than this.
After puberty, many women develop a regular cycle with a similar length of time between periods. But it’s not uncommon for it to vary by a few days each time.
Causes of irregular periods
There are many possible causes of irregular periods. Sometimes they may just be normal for you.
Common causes include:
- puberty – your periods might be irregular for the first year or two
- the start of the menopause (usually between the ages of 45 and 55)
- early pregnancy – take a pregnancy test to rule this out
- some types of hormonal contraception – such as the contraceptive pill or intrauterine system (IUS)
- extreme weight loss or weight gain, excessive exercise or stress
- medical conditions – such as polycystic ovary syndrome (PCOS) or a problem with your thyroid
When to see a GP
You don’t need to get medical advice if you have always had slightly irregular periods or you’re still going through puberty.
But see a GP if:
- your periods suddenly become irregular and you’re under 45
- you have periods more often than every 21 days or less often than every 35 days
- your periods last longer than 7 days
- there’s a big difference (at least 20 days) between your shortest and longest menstrual cycle
- you have irregular periods and you’re struggling to get pregnant
There might not be anything wrong, but it’s a good idea to get checked out to see what the cause might be.
You might be referred to a specialist called a gynaecologist if you need any tests or treatment.
Trying for a baby
It can be more difficult to get pregnant if you have irregular periods because you might not ovulate (release an egg) regularly.
It can help to have sex every 2 or 3 days throughout your cycle. You don’t need to time sex around ovulation.
Read more about trying to get pregnant.
Sometimes hormone medicine or fertility treatment may be needed if you’re struggling to get pregnant naturally.
More about periods and other period problems
Read more about:
Video: menstrual cycle
This animation explains in detail how the menstrual cycle works.
Media last reviewed: 21 October 2020
Media review due: 21 October 2023
Page last reviewed: 27 April 2021
Next review due: 27 April 2024
Causes and What to Do
Bleeding or spotting between regular monthly periods can alarm you. When this happens, you may see just a spot or two of blood on your underwear or toilet tissue, or you may be bleeding as if you have started your period. While there are harmless reasons for this to happen, it can also point to more serious problems that need medical treatment.
What Is and Isn’t Spotting
It’s common for people to refer to any bleeding outside of a period as spotting. However, spotting, breakthrough bleeding, and other issues differ in the timing and amount of bleeding.
- Spotting: This includes just a red tinge on the toilet paper or a drop or two in your underwear. Medically, it’s considered spotting if it’s outside of your period and doesn’t generally require you to use a pad or tampon.
- Light bleeding: This type of bleeding occurs just before or after your period and isn’t technically spotting—it’s considered part of your period.
- Breakthrough bleeding: Mid-cycle bleeding is heavier than spotting.
Bleeding separate from your period that’s heavy enough to require feminine products is called breakthrough bleeding.
- Breakthrough bleeding is defined as mid-cycle bleeding if you are taking oral contraceptives, and it’s usually caused by estrogen levels too low to suppress the natural menstrual cycle.
- If heavy bleeding outside of your cycle isn’t tied to oral birth control pills, it is defined as abnormal uterine bleeding or abnormal vaginal bleeding.
Normal Menstrual Bleeding
Normal menstrual bleeding lasts for about five to seven days. While menstruation usually occurs an average of every 28 days, between 21 to 35 days between periods is considered normal.
Most females get to know their own cycles after a few years of menstruating. Although it may seem like you are losing a lot of blood, it usually only measures between two and eight tablespoons.
About 14 days after the start of your period, you ovulate and release an egg from the ovary.
- Some people notice spotting during ovulation, which can be normal, but should be discussed with your doctor.
- If no fertilized egg implants, the uterine lining is shed during menstrual bleeding approximately two weeks after ovulation.
Causes of Spotting
Although the reasons for irregular bleeding can vary according to individual health situations, pregnancy, birth control, and infection are some of the more common causes.
Verywell / Jessica Olah
Several possible causes are related to pregnancy:
- Implantation bleeding: Spotting may occur at the time the fertilized egg implants in the uterus and begins to grow.
- Miscarriage: You may or may not have known you were pregnant, and the bleeding may be a sign that the pregnancy has ended.
- Ectopic pregnancy: This occurs when a fertilized egg implants outside of the uterus.
- Abortion: Bleeding can occur after terminating a pregnancy using medication or a procedure.
You may see bleeding related to your birth control method:
- Oral contraceptives: Starting, stopping, or missing oral contraceptives (birth control pills) can lead to spotting or bleeding.
- Other hormonal birth control methods: Irregular vaginal bleeding might be seen when using the contraceptive patch, implant, or injection.
- Intrauterine devices (IUDs): Intrauterine devices are known to cause occasional spotting.
Bleeding may be seen in conditions that affect your hormones:
There are several infectious diseases that may cause bleeding:
Bleeding Around Your Period
Light bleeding right before or after your period is not considered spotting but is just a normal part of your period.
Various possible causes include:
- Endometriosis (abnormal growth of uterine tissue outside the uterus)
- Injury to the vagina from the insertion of foreign objects or sexual trauma
- Uterine fibroids (noncancerous growths in the uterus)
- Malignant cancers, including cervical cancer, uterine cancer, uterine sarcoma, ovarian cancer, and vaginal cancer
- Certain drugs, particularly anticoagulants and tamoxifen
- Certain gynecological procedures
- Urethral prolapse or polyps
When to See a Doctor
Use your menstrual cycle calendar to record the number of tampons or pads you use. This information can help your doctor determine whether or not you are bleeding excessively.
Any unexplained vaginal bleeding between periods is a reason to call your healthcare provider. While it needs to be reported at any age, it is especially a concern for people who haven’t yet gone through puberty and for females who are past menopause.
If you are pregnant and you have spotting or bleeding, you need to see your doctor.
You should seek immediate medical care if the bleeding is heavy, or if it is accompanied by pain, fever, dizziness, chills, nausea, or vomiting.
You should expect to give your full medical history when you visit your healthcare provider for a diagnosis of bleeding or spotting between periods. If you’ve kept a menstrual cycle calendar, it will help.
Your provider may ask:
- How long have you experienced bleeding between periods?
- Does it happen every month or is this the first time?
- At what point during your menstrual cycle did the bleeding begin and how long did it last?
- Do you experience menstrual cramps when bleeding between periods occurs?
- Does anything make the bleeding worse or better?
- Is the bleeding worse with increased physical activity?
If you are pregnant or recently had a miscarriage or abortion, it is important to let your doctor know. The same applies if you have experienced any injury or undergone any intrauterine medical or surgical procedure.
If you’re visiting a doctor for the first time, they’ll want to know how old you were when you first started having periods, whether you’re sexually active, and what birth control method you may be using.
Remember to inform your healthcare provider about any prescription or over-the-counter medications (including herbal supplements) that you are taking.
You might have a pelvic exam, including a Pap smear if you haven’t had one recently. Additional tests, such as blood tests or imaging tests might be needed as well.
The treatment for your vaginal or uterine bleeding will depend on your diagnosis.
Frequently Asked Questions
What is the most common cause of bleeding between periods?
The most common cause of bleeding between periods is hormonal and can include the use of hormonal contraceptives or the process of going through menopause.
Who is most likely to experience breakthrough bleeding on hormonal contraceptives?
Women who smoke or skip birth control pill doses are more likely to experience breakthrough bleeding than non-smokers or those who adhere to the prescribed hormonal contraceptive schedule.
Should I be concerned if bleeding between periods is accompanied by other symptoms?
If you experience fever, dizziness, bruising, or pain while bleeding between periods, you should contact your doctor.
A Word From Verywell
You are right to be concerned about abnormal vaginal bleeding, and you should discuss it with your doctor. While it may have a cause that is only a minor concern, it can also be a sign of a condition that needs attention, including pregnancy or miscarriage.
Are Multiple Periods a Reason to Worry?
The occasional double period in a month is usually not a reason for concern. However, it’s important to see a health care provider if you experience any of the following:
- 2 periods in a month for 2 to 3 consecutive months
- Heavy periods
- Large blood clots during periods (the size of a quarter or bigger)
- Lower abdominal pain, especially if it doesn’t get better within one to two days
- Severe menstrual cramps
- Light bleeding or spotting between periods, which can easily be mistaken as 2 periods in a month, that repeats from month to month
- Pain during sex
The treatment for two periods in one month depends on the cause of the bleeding. People who have a short menstrual cycle naturally or who are in the early stages of puberty typically don’t require treatment.
Health care providers may suggest hormonal birth control as a possible treatment for multiple periods in a month, as it can help regulate periods and resolve anemia that occurs due to heavy and frequent bleeding. If you’re already taking hormonal birth control and you think it might be causing you to have a period twice in one month, then be sure to talk to a health care provider.
For hypothyroidism, a health care provider may prescribe thyroid hormone replacement therapy. For hyperthyroidism, several treatment options are available, and health care providers will suggest the one that is best for each condition.
During perimenopause, health care providers may suggest menopausal hormone therapy to regulate periods until they cease with menopause.
For uterine fibroids, health care providers may recommend different therapies, including an intrauterine device, uterine artery embolization, or surgery.
Certain lifestyle changes can also help reduce stress, which certainly impacts the menstrual cycle. Possible changes include exercising regularly, practicing meditation, reducing caffeine intake, and listening to soothing music.
While having a period twice a month may be somewhat normal for people with a short menstrual cycle, it can be surprising for those who tend to have a cycle that’s longer.
In many cases, there’s no reason to worry about having a period twice a month, but sometimes it can indicate an underlying medical issue.
Since there are many different reasons for having two periods in one month, the best course of action is to mention it to your health care provider. They can help figure out the reason behind it and determine an action plan.
What Does Your Menstrual Cycle Say About Your Fertility?
One of the most common questions OB/GYN’s have for their patients is “When was the first day of your last period?”. The answer to this question may feel like part of the usual routine at your annual OB/GYN appointment. If you have been trying to conceive without success, the answer could provide important insight into factors central to the menstrual cycle and conception such as hormonal imbalances and ovulation.
What is a menstrual cycle?
Hint, it is more than just your period. The menstrual cycle is a series of changes a woman’s body goes through each month whereby the ovary releases an egg and the uterus prepares for pregnancy. The cycle can be divided into two phases: the follicular phase and the luteal phase.
The first day of your menses – or period – is day 1 of your cycle and the start of the follicular phase. During this phase, follicle stimulating hormone (FSH), is released from the brain to stimulate the development of a single dominant follicle which contains one egg. During its maturation, the follicle releases estrogen which stimulates growth and thickening of the uterine lining. The follicular phase concludes at the start of ovulation – the process of releasing a mature egg from the dominant follicle. The length of the follicular phase is variable between individuals, resulting in most variations of total cycle length.
The luteal phase starts after ovulation and continues until the onset of the next menses. During this phase, the ovary releases progesterone which changes the uterine lining and opens the window of implantation – the time during which the embryo can attach to the uterus. If pregnancy does not occur, the progesterone level drops and bleeding occurs. The luteal phase is usually between 12-14 days.
Does the length of a menstrual cycle matter?
The length of a menstrual cycle is determined by the number of days from the first day of bleeding to the start of the next menses. The length of your cycle, while not on any form of birth control, can be a key indicator to hormonal imbalances and whether or not ovulation is occurring in a predictable manner. Hormonal imbalances can affect if and when ovulation occurs during your cycle. Without ovulation, pregnancy cannot occur.
Normal menstrual cycle:
Days: 24 to 35 days
Ovulation Indicator: Regular cycles indicate that ovulation has occurred
What Do Normal Cycles Tell Your Doctor? Cycles of a normal length suggest regular ovulation and that all of the sex hormones are balanced to support natural conception.
Short menstrual cycle:
Days: Less than 24 days
Ovulation Indicator: Ovulation may not have occurred or occurred much earlier than normal
What Do Short Cycles Tell Your Doctor? Shortened cycles can be an indication that the ovaries contain fewer eggs than expected. This is typically a pattern seen in women in the years leading up to perimenopause. Alternatively, a short cycle could indicate that ovulation is not occurring. If blood work confirms this to be the case, natural conception can be more difficult.
What Causes a Shorter Cycle? As a woman grows older, her menstrual cycle shortens. As the number of eggs available in the ovary decrease, their quality also declines. These dysfunctional ovaries lose their ability to effectively communicate with the brain. Additionally, the brain needs to release more follicle stimulating hormone (FSH) to stimulate these abnormal eggs to mature. As a result, the dominant follicle is ready for ovulation very early in the follicular phase and consequently produces a short cycle length. In addition, sometimes bleeding can occur even when ovulation does not occur, and this may appear as shortened and irregular cycles.
Long or irregular menstrual cycle:
Days: More than 35 days
Ovulation Indicator: Ovulation is either not occurring or occurring irregularly
What Do Longer Cycles Tell Your Doctor? Longer cycles are an indicator that ovulation is not occurring or at least not in a regular manner which can make conception difficult.
What Causes Long Menstrual Cycles? Longer cycles are caused by a lack of regular ovulation. During a normal cycle, it is the fall of progesterone that brings upon bleeding. If a follicle does not mature and ovulate, progesterone is never released and the lining of the uterus continues to build in response to estrogen. Eventually, the lining gets so thick that it becomes unstable and like a tower of blocks, eventually falls and bleeding occurs. This bleeding can be unpredictable, and oftentimes very heavy and lasting a prolonged period of time.
There are many causes of oligo-ovulation, the medical term used to describe when ovaries do not grow a dominant follicle and release a mature egg on a regular basis. Polycystic ovarian syndrome (PCOS), the most common cause for oligo-ovulation, is a syndrome resulted from being born with too many eggs. This can result in an imbalance in the sex hormones, and failure to grow a dominant follicle and unpredictable or absent ovulation. In addition, irregularities with the thyroid gland or elevations of the hormone prolactin can disrupt the brain’s ability to communicate with the ovary and result in anovulation.
When menstrual bleeding lasts more than 5-7 days:
Days: More than 7 days
Ovulation Indicator: It is possible that there is a hormonal problem resulting in a delay in follicular growth or a structural problem in the uterus making the lining unstable.
What Do Longer Cycles Tell Your Doctor? Prolonged bleeding tells your doctor that the ovary is not responding to the brain signals to grow a lead follicle. This can be a sign of a delayed or absent ovulation. Alternatively, there may be something disrupting the lining of the uterus.
What Causes Long Periods of Bleeding? There are many causes of prolonged bleeding. From a hormonal perspective, what stops a woman’s period is estrogen from the growing follicle. If follicular growth is not occurring regularly, then prolonged and irregular bleeding can occur. Intermenstrual bleeding or prolonged bleeding may be caused by structural problem like polyps, fibroids, cancer or infection within the uterus or cervix. In these situations, should an embryo enter the uterus, implantation can be compromised resulting in lower pregnancy rates or an increased chance of a miscarriage. Although rare, a problem with blood clotting can also cause prolonged bleeding and this requires evaluation and care by a specialist.
What if I never menstruate?
Days: Rarely or Never
Ovulation Indicator: Ovulation may not be occurring
What does a Lack of Menstruation tell your Doctor? Either ovulation is not occurring or there is something blocking menstrual blood flow. The patient will have difficultly conceiving naturally without intervention.
What Causes Cycles to Stop Occurring? When a woman does not have a period, this can be caused by a failure to ovulate. Hypothalamic amenorrhea is a potential cause, as well as any of the hormonal imbalances that can cause irregular cycles can also stop the cycles completely. It is common in women who are considered underweight by the body mass index (BMI) standards to stop having a cycle. The body requires a certain level of body fat for reproduction and menstrual cycles to occur, and many women who are able to gain weight will see the return of their cycle.
Weight is not the only cause to consider. There are several other causes that should be evaluated as well. If a woman has never had menstrual bleeding, there may have been a problem with the normal development of the uterus or the vagina. If a woman had menstrual cycles previously, but then stopped, this could be due to a problem with the uterus itself, like scar tissue inside the cavity, or may be due to premature menopause. If the uterus has not formed or if menopause has occurred, pregnancy is not possible. If the absence of menses is due to scar tissue inside the uterus, then this scar tissue will need to be removed as it can interfere with implantation.
If you do not have a normal monthly menses, no matter the amount of time you have been trying to conceive, you should be evaluated by a specialist. Irregular or absent ovulation makes conception very difficult without intervention. Any woman less than 35 years of age with normal cycles who has not gotten pregnant after a year of trying should see an infertility specialist. If you are 35 or older with a normal menstrual cycle and have been trying for 6 months without success, you should seek care as well. Normal menstruation indicates that you are ovulating; however, there are other reasons why you may not be able to get pregnant, and these should also be evaluated.
Editor’s Note: This post was originally published in October 2014 and has been updated for accuracy and comprehensiveness as of March 2021.
For more information about your menstrual cycle or to schedule an appointment with one of our physicians, please speak with one of our New Patient Liaisons at 877-971-7755 or fill out this brief form.
Abnormal Vaginal Bleeding | Cigna
Are you having any abnormal vaginal bleeding?
Bleeding is abnormal if it occurs at a time when you aren’t expecting it or if it’s a lot heavier or lighter than what you are used to.
Abnormal vaginal bleeding
Abnormal vaginal bleeding
How old are you?
11 years or younger
11 years or younger
12 to 55 years
12 to 55 years
56 years or older
56 years or older
Are you male or female?
Why do we ask this question?
- If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
- If your symptoms aren’t related to those organs, you can choose the gender you identify with.
- If you have some organs of both sexes, you may need to go through this triage tool twice (once as “male” and once as “female”). This will make sure that the tool asks the right questions for you.
Are you pregnant?
Yes, you know that you’re pregnant.
No, you’re not pregnant, or you’re not sure if you’re pregnant.
Have you been skipping periods or bleeding a lot less than usual?
Periods are absent or lighter than usual
Periods are absent or lighter than usual
Has vaginal bleeding started before age 9?
Vaginal bleeding started before age 9
Vaginal bleeding started before age 9
Do you feel lightheaded or dizzy, like you are going to faint?
It’s normal for some people to feel a little lightheaded when they first stand up. But anything more than that may be serious.
Do you have new pain in your lower belly, pelvis, or genital area that is different than your usual menstrual cramps?
Lower abdominal, pelvic, or genital pain
Lower abdominal, pelvic, or genital pain
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: Severe pain
5 to 7: Moderate pain
1 to 4: Mild pain
Has this amount of bleeding been going on for 4 hours or longer?
Bleeding 4 hours or more
Bleeding 4 hours or more
Is the bleeding happening at an expected time during your menstrual cycle?
Bleeding is at expected time during menstrual cycle
Bleeding is at expected time during menstrual cycle
Do you think that the symptoms may have been caused by sexual abuse?
Possible sexual abuse
Have you been bleeding for more than 2 weeks without stopping?
Bleeding for more than 2 weeks without stopping
Bleeding for more than 2 weeks without stopping
Do you think you may have a fever?
Do you have a rash that looks like a sunburn?
Do you have any bleeding after intercourse or douching?
Vaginal bleeding after intercourse or douching
Vaginal bleeding after intercourse or douching
Do you think that a medicine may be causing the bleeding?
Think about whether the bleeding started after you began using a new medicine or a higher dose of a medicine.
Medicine may be causing vaginal bleeding
Medicine may be causing vaginal bleeding
Do you use a form of birth control that contains hormones?
This could be birth control pills, implants, vaginal rings, skin patches, injections, or an IUD that contains hormones.
Hormonal birth control method
Hormonal birth control method
If your periods have stopped because of menopause, has it been at least 6 months since your last one?
In menopause and 6 months since last period
In menopause and 6 months since last period
Are you taking hormone replacement therapy, such as estrogen or progestin?
Hormones can cause changes in your normal bleeding patterns, especially when you first start taking them.
Hormone replacement therapy
Hormone replacement therapy
Have you had abnormal bleeding for at least 2 cycles or more than once a month?
Bleeding has occurred for at least 2 cycles or more than once per month
Bleeding has occurred for at least 2 cycles or more than once per month
Have your symptoms lasted longer than 2 weeks?
Symptoms for more than 2 weeks
Symptoms for more than 2 weeks
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
- Your age. Babies and older adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
- Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
- Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
- Try home treatment to relieve the symptoms.
- Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
Severe vaginal bleeding means that you are soaking 1 or 2 pads or tampons in 1 or 2 hours, unless that is normal for you. For most women, passing clots of blood from the vagina and soaking through their usual pads or tampons every hour for 2 or more hours is not normal and is considered severe. If you are pregnant: You may have a gush of blood or pass a clot, but if the bleeding stops, it is not considered severe.
Moderate bleeding means that you are soaking more than 1 pad or tampon in 3 hours.
Mild bleeding means that you are soaking less than 1 pad or tampon in more than 3 hours.
Minimal vaginal bleeding means “spotting” or a few drops of blood.
Many prescription and nonprescription medicines can cause changes in vaginal bleeding. A few examples are:
- Aspirin and other medicines (called blood thinners) that prevent blood clots.
- Corticosteroids, such as prednisone.
- Hormone therapy.
- Thyroid medicines.
Pain in adults and older children
- Severe pain (8 to 10): The pain is so bad that you can’t stand it for more than a few hours, can’t sleep, and can’t do anything else except focus on the pain.
- Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it’s severe when it’s there.
- Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.
Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.
Adults and older children often have several symptoms of shock. These include:
- Passing out (losing consciousness).
- Feeling very dizzy or lightheaded, like you may pass out.
- Feeling very weak or having trouble standing.
- Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
- Call your doctor now to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don’t have one, seek care in the next hour.
- You do not need to call an ambulance unless:
- You cannot travel safely either by driving yourself or by having someone else drive you.
- You are in an area where heavy traffic or other problems may slow you down.
Seek Care Today
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
- Call your doctor today to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don’t have one, seek care today.
- If it is evening, watch the symptoms and seek care in the morning.
- If the symptoms get worse, seek care sooner.
Make an Appointment
Based on your answers, the problem may not improve without medical care.
- Make an appointment to see your doctor in the next 1 to 2 weeks.
- If appropriate, try home treatment while you are waiting for the appointment.
- If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.
Call 911 Now
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
Sometimes people don’t want to call 911. They may think that their symptoms aren’t serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.
Missed or Irregular Periods
90,000 what every woman in her 30s, 40s and 50s should know?
The mood and well-being of every woman largely depends on the successful functioning of her reproductive (reproductive) system.
Cyclic changes in the female body occur over decades, and each age period has its own pitfalls. It is important to be able to recognize warning symptoms in time in order to prevent more serious health consequences.
Any violation of the menstrual cycle is not a disease, but a call that reminds a woman that it is time to listen to the signals of her body.
Important to know! The nature of menstruation is different for each woman. Normally, it changes throughout a woman’s life in response to changes in the body, age and health.
The menstrual cycle by the age of 30 for most young women is usually well-established and predictable. Reproductive function is in full swing.
Changes in the nature of menstruation are possible when changing oral contraceptives.
When amenorrhea occurs – the absence of menstruation for several weeks or months, then a visit to the doctor is necessary.If a woman is not pregnant and is not breastfeeding during this period, disappeared menstruation can be a symptom of various diseases: from inflammation of the appendages of the uterus to an imbalance of hormones. Severe stress, a trendy diet, and even a simple change of jet lag can provoke amenorrhea.
Painful periods (algodismenorrhea) occur in young women before the first birth. This unpleasant condition annoys a woman with inflammatory diseases of the genital area, endometriosis, uterine fibroids and even intrauterine contraception.
Uterine bleeding can be disguised as heavy periods. If the hygiene products have to be changed every 1-2 hours, or more often, then it is worth sounding the alarm, but without panic. In more severe cases, bleeding becomes uncontrollable and dangerous. Urgent medical attention is needed. Causes: diseases of the uterus, ovaries, hormonal imbalance, medication and diseases not related to the reproductive organs.
Age 40 years
At the age of 40, as you know, life is just beginning.In many ways, this is indeed the case. With the development of reproductive technologies, women can become a mother for the first time only after forty – forty-five years.
The word “menopause” for our contemporaries is just a word. But nature takes its toll: restructuring in the body begins several years before a woman enters a new age period. It will mark the end of reproductive function.
Between the ages of 40 and 50, the ovaries produce less and less estrogen. Premenopause begins when menstrual problems are inevitable.Already 8-10 years before the onset of menopause, changes in the menstrual cycle may begin due to the gradual extinction of this function.
Menstruation periodically begins to malfunction: in some they are scarce and irregular, while in others they become much more abundant, while the cycle itself can be shortened. Sometimes your period doesn’t come during the expected period.
Cysts, fibroids, chronic inflammatory diseases of the genital area and endocrine problems in the body, diet, and not only age-related changes, affect the nature of menstruation after 40 years.
What needs special attention? Bloody discharge in the interval between two cycles, lengthening of menstruation for more than 7 days. Uterine fibroids are a common disease at this age. Prolonged discharge, even if they are scarce, discomfort in the lower abdomen should alert the woman. The examination does not need to be postponed.
And just the absence of menstruation in this transitional age period also requires examination by a doctor. Some women aged 40+ are faced with such a surprise as an unplanned pregnancy, which was mistaken for an incipient menopause.
Age 50 years
By this age, if a woman has not yet entered the period of menopause, physiological changes in the menstrual cycle occur. The intervals between periods become longer, until menstruation completely disappears. If a woman’s menstruation has been absent for a year or more, and then resumed, then this may be an alarming symptom.
Some women over 50-55 years old have a regular cycle. High hormone levels provide energy and activity.Late menopause protects women from heart disease, but due to the increased level of hormones, it is worth regularly undergoing examinations by a gynecologist and mammologist.
Almost every woman is faced with one or another violation of the menstrual cycle. The female genital area is receptive and sensitive, like the woman herself.
Menstruation problems are not always caused by an illness, because it can be just high loads in the gym, and a fashionable diet, and emotional shock and a long-awaited pregnancy.
Valeologist of the Department of Prevention M. Vereshchagin
Menstrual cycle: what is normal and what is not? – Academic Medical Center (AMC)
How long should the menstrual cycle last? How heavy should be your period? What if they become scarce or, conversely, too strong? Why does the stomach hurt during menstruation and how to cope with this pain? What is the norm and what about the problem? All about how menstruation should go and what to do in case of emergency was told by a doctor of the highest category, obstetrician-gynecologist of the Akamedian Medical Center Lesya Demyanenko.
Lesya Vladimirovna, tell us how your periods should go normally?
– The normal menstrual cycle is 28 to 35 days, and menstruation itself should last from 3 to 7 days and be moderate. Menstruation should normally be painless and pass without PMS. This is ideal, but there are very few women who really experience it this way.
Why are periods accompanied by painful sensations?
– If menstruation is painful, a woman of any age should be examined and consult a doctor.Pain during menstruation can be caused by various diseases, such as endometriosis. If a woman has been examined and no pathologies have been found, then the doctor may recommend that she take lubricants and non-steroidal anti-inflammatory drugs before the onset of menstruation. This usually helps relieve pain during your period.
If your period is too short or too heavy, what to do? What could be causing this?
– Menses should be moderate.If they were moderate, and then became scarce or abundant, you need to pay attention to this and get tested. If menstruation becomes scarce in a young woman, this may indicate that she has premature ovarian depletion, or hormonal problems with the pituitary gland, or thyroid gland. Lean menses are most often associated with endocrinological diseases.
Abundant menstruation can be caused by organic diseases: either endometrial hyperplasia, or endometrial polyps, or fibroids.All these diseases require medical or surgical treatment.
If too much bleeding occurs during menstruation, you should immediately consult a doctor, without waiting for their end. The reasons can be different, and they need to be established. The appearance of profuse bleeding, which began on the expected date of menstruation, can be triggered by the loss of pregnancy or an ectopic pregnancy. In both cases, urgent hospitalization and surgical treatment are required. Also, bleeding can also cause a polyp, which was previously small in size and therefore did not give any symptoms.
What symptoms should I see a doctor for?
– You need to go to the doctor if the menstrual cycle changes, the duration of menstruation, the abundance of discharge, pain appears during menstruation. If any symptoms appear, do not delay the examinations. At first glance, insignificant changes may indicate a serious problem that is better solved immediately, without waiting for it to get worse.
90,000 Possible Causes of Prolonged Menstruation | Moscow
If the due date has passed, and your period has not ended, this is a reason to think about your health and see a doctor
Indeed, behind this seemingly harmless problem, serious illnesses can be hidden.
Menstruation for a woman is always a source of various experiences and worries. Delayed or started earlier than expected, did not go as usual, and so on. But perhaps most worried about when menstruation lasts longer than expected.
What determines the duration of your period?
A woman’s menstrual cycle is entirely dependent on her hormonal status. Both sex hormones and thyroid and adrenal hormones play a decisive role.Depending on their concentration and ratio, at each moment of time, both the duration and the nature of menstruation depend.
Normally, the duration of menstruation is 3-7 days, but if it exceeds this value, then you should consult a doctor, and the sooner, the better. The fact is that the cause of prolonged menstruation can be a variety of factors, ranging from stress and hormonal disruption to serious diseases of the pelvic organs.
Possible causes of prolonged periods
The menstrual cycle is determined by the level of hormones, but a variety of factors can affect their production.Most often, prolonged menstruation is due to the following problems:
- Unidentified hormonal background. Prolonged menstruation can be in girls during puberty, in women during menopause.
- Hormonal disorders. Prolonged periods can be the result of hormonal disorders. They are caused by a variety of factors, such as stress, overexertion, unhealthy diet, sudden weight gain, chronic diseases such as diabetes and obesity, and many others.Long-term use of certain medications can also negatively affect the menstrual cycle.
- Diseases of the endocrine system. Certain diseases of the endocrine glands, primarily the thyroid gland and adrenal glands, can lead to disruption of the cycle.
- Ovarian diseases. Many ovarian diseases affect the regularity of the menstrual cycle. It can be either acute or chronic inflammation of the appendages, and neoplasms of the ovaries, such as cysts and tumors, and many other problems.
- Diseases of the uterus. Prolonged menstruation can be caused by some diseases and formations in the uterus, for example, endometriosis of the uterus, fibroids, polyps and endometrial hyperplasia, malignant formations can occur. Of the acute inflammatory diseases, endometritis is most often diagnosed.
- Using an intrauterine device. Sometimes some women who have an intrauterine device installed, note that their menstruation has become longer, there may also be prolonged spotting spotting after menstruation.
- Hormonal preparations. In some cases, the use of hormonal drugs can also lead to changes in the menstrual cycle.
- Disorder in the blood coagulation system. Sometimes menstruation does not end due to a sharp drop in blood clotting factors.
Of course, the list does not end there, but the reasons presented are the most likely ones.
Prolonged bleeding against the background of delayed menstruation. This may be a sign of threatened termination of pregnancy. It is also necessary to exclude an ectopic pregnancy, as this can threaten a woman’s life.
Consequences of abortion. Spotting can last up to 2–3 weeks after medical abortion. This is not menstruation, but bleeding associated with changes in hormonal levels and endometrial rejection. Bleeding may last a little less after surgical or vacuum abortion.
All situations in which menstruation lasts more than 7 days or this menstruation came abundantly and for a long time after a delay, require immediate medical attention and urgent measures to stop bleeding.
What to do with prolonged periods?
If menstruation does not end on day 7-8, the first thing to do is see a gynecologist. This is the best thing that can be done in such a situation, any independent actions can only harm.
An even greater threat is posed by a situation when menstruation is not only prolonged, but also abundant. Normally, during menstruation, a woman loses about 80 ml of blood.
With heavy menstruation, a woman notes large blood clots, every 2 hours it is necessary to change the maximum volume pad or tampon, change hygiene products at night.Abundant blood loss is accompanied by a loss of strength, skin poverty, perspiration, pain in the lower abdomen, in this case, you must immediately consult a doctor for an appointment or call an ambulance, no matter what time of day it happens.
Examination for prolonged menstruation
If a woman goes to a doctor with complaints of prolonged menstruation, then first of all she will need to undergo a basic examination:
- Gynecological examination. The doctor will examine the genitals and determine the nature of the discharge.
- ultrasound. With its help, you can study the structure of the internal genital organs, determine the presence of changes in the uterus and ovaries.
- Determination of the hormonal profile. An important indicator is the level of some hormones: FSH, LH, estradiol, prolactin, thyroid hormones, adrenal hormones.
- Determination of the number of platelets and indicators of the blood coagulation system.
It is imperative to check the level of hemoglobin and ferritin to exclude anemia and iron deficiency.
If there is a suspicion of an inflammatory process, you may need to be tested for latent infections.
Based on the results of the examination, the doctor will be able to determine the cause of the menstrual irregularity and select the necessary treatment.
Why your period lasts longer than usual – HEROINE
Menstruation is quite annoying in itself, but when it lasts longer than usual it is especially troubling.The menstrual cycle is easy to change due to stress, diet, and medications, but in some cases, the causes can be much more complex. The average length of menstruation is three to five days, although many girls report that their difficult days can last up to an entire week. If this is your case, there is nothing to worry about, but if the length of your cycle has suddenly changed, it makes sense to check your health. Heroine has compiled several reasons why a regular cycle can fail, and menstruation lasts longer than usual.
The main reason why you basically have your period is because your body receives a signal that you are not pregnant, so the level of estrogen and progestin drops, and the level of prostaglandin rises. This signals the uterus that it should get rid of the mucous membrane created for a possible pregnancy.
If a hormonal imbalance causes estrogen and progestin levels to remain unchanged, it can lengthen your period.Fortunately, this is usually not something to worry about – it will most likely change by itself by the next cycle.
The thyroid gland is a small organ in the front of the neck that secretes hormones that affect most of the body’s processes. Disruptions in performance are usually caused by a lack of iodine in the diet or various autoimmune disorders, such as Hashimoto’s disease.
At least one third of women between the ages of 30 and 40 face this problem, but the situation is not so difficult to remedy.If you think that changes in your menstruation may be associated with an enlarged gland, then you need to undergo an examination by an endocrinologist and receive appropriate treatment.
Change of contraceptive method
According to Everyday Health, certain birth control pills can affect the frequency and length of your menstrual cycle. If you have recently changed the method of contraception, prolonged bleeding may be part of the adaptation. You should wait at least three cycles using this new method for your periods to correct, but if this is a serious concern, make an appointment with your gynecologist.
Polyps are abnormal growths of tissue that can occur in any organ, including the uterus. In some cases, this is the reason that menstruation lasts longer than five days, and sometimes there are even gaps between bleeding. Usually polyps are benign, but some of them can be unhealthy, so it is worth getting a full examination to rule out the possibility of developing cancer.
Sexually transmitted diseases
An unusually long and painful period is a symptom of an STD.For example, if you bleed profusely for seven days, this could be a sign of chlamydia, especially if it is accompanied by painful urination and pelvic pain. Fortunately, most diseases are easily treatable early, so if you notice other unpleasant symptoms, it makes sense to get tested as soon as possible.
Cysts in the ovaries
Cysts in the ovaries are a common occurrence that causes irregular prolonged periods, but you should not panic about their presence.Most cysts are benign, although the largest cysts can interfere with normal blood flow. They usually disappear on their own, but for control it is still worth undergoing a regular examination by a doctor.
If you have more than one cyst, this may indicate polycystic ovary syndrome and, according to some reports, this can lead not only to difficult menstruation, but also to further infertility. That is why the disease should be diagnosed at an early stage in order to start treatment as soon as possible.
One long period that is severely delayed may be the result of a miscarriage. According to researchers at the Mayo Clinic, 40% of women experience miscarriage without even knowing they are pregnant. If menstruation came on time, miscarriage is unlikely, but if, according to your calculations, the dates do not agree, there is a chance that the embryo did not take root.
How do you track your cycle?
Add to favorites
How to correctly calculate the gestational age and determine the date of birth
By itself, a delay in the start of a new menstrual cycle does not necessarily indicate pregnancy – failures can be explained by diseases, excessive physical exertion or stress.Pregnancy must be confirmed by a hCG test or examination on a gynecological chair.
1) Blood test for hCG
An excess of the concentration of the “pregnancy hormone” or human chorionic gonadotropin (hCG) in a woman’s blood makes it possible to diagnose pregnancy very early, in the first days after its onset, long before a delay in the menstrual cycle appears or the woman feels the first symptoms. Also, an analysis for the level of hCG in the blood allows you to determine the duration of pregnancy with an accuracy of about two weeks.
2) Home pregnancy test
The principle of operation of home pregnancy tests is also based on measuring the level of hCG, but their sensitivity is lower than that of a blood test. The most modern of them can not only confirm the presence of pregnancy a few days before the onset of the delay, but also indicate (not too accurately) the approximate time.
Tests of the old generation will show a more or less accurate result only after a delay, that is, after 2-4 weeks from conception.
3) Gynecological examination
A qualified obstetrician gynecologist can diagnose pregnancy during an examination starting from 3-4 weeks after conception, focusing on changes in the shape and size of the uterus, as well as other signs.
4) Ultrasound examination
Ultrasound is the most accurate way to diagnose pregnancy. With the help of an ultrasound examination with a transvaginal sensor, it is possible to determine the presence of an ovum in the uterus within 1-2 weeks after conception (3-4 obstetric weeks), but fetal heartbeats can be detected only at a period of 5-6 obstetric weeks.Determining the gestational age with high accuracy (up to 2-3 days!) With the help of ultrasound, it is possible to accurately determine only from 6-7 weeks.
If the delay, as well as the result of a test or blood test for hCG indicate that you will soon become a mother, do not rush to immediately do an ultrasound scan. Wait another 2-3 weeks, then the ultrasound will not only determine the exact time, but will also let you listen to the baby’s heartbeat.
If you did not begin to do an ultrasound scan at an early stage to confirm pregnancy, then for the first time you will come across this study at 10-14 weeks.At the same time, the exact duration of pregnancy and PDD will be established or corrected for you. During pregnancy, you will need to undergo this examination at least twice more. This will happen at 20-24 and 30-34 weeks. However, it should be said that ultrasound in the 2nd and 3rd trimesters may have an error in determining the duration of pregnancy. The PDD established for them may differ from the real one by 2-3 weeks. That is why it is so important not to miss the first screening and do an ultrasound examination on time.
It just so happens that the child-bearing function is activated in the girl’s body at the moment when she does not care about this function at all.Having just put the doll aside, the girl is confronted with a whole series of obscure processes taking place in her body, which immediately begin to be vigorously discussed in the circle of her peers with consultations with those who are older. And mothers in this situation do not always turn out to be at their best, since they themselves are poorly guided in this topic.
So, let’s once and for all figure out what happens to you every month, dear women, what should be considered the norm, what should alert you.
Most women, when asked about the length of their menstrual cycle, respond with a similar phrase “about once a month, a couple of days earlier than the previous month” – this convoluted phrase denotes a cycle duration of 28 days. Such a cycle length is found in most healthy women, but does this mean that a shorter or longer cycle is a manifestation of pathology? No!
It is recognized that a normal menstrual cycle can last from 21 to 35 days , that is, plus or minus a week from an average of 28 days.The duration of the menstruation itself can normally range from 2 to 6 days, and the volume of blood lost should be no more than 80 ml. A longer cycle occurs in women from northern regions, a shorter cycle in southern ones, but this is not an absolute regularity.
Regularity of the menstrual cycle is important. That is, if a woman’s cycle is always 35-36 days, then for her it may be absolutely normal, but if it is then 26, then 35, then 21 – this is not the norm. Thus, pathology can be considered irregularity (when menstruation comes at an unequal interval of time), long cycle (more than 36 days) or short cycle (less than 21 days).In general, the menstrual cycle can vary greatly depending on the condition of the woman and the situation in which she is.
However, in different women, the lability of the menstrual cycle, depending on external and internal factors, is different. For some, a little stress can already lead to a delay in menstruation, while for others, severe depression is not a reason for menstrual irregularities. The menstrual cycle of one woman can adjust to the menstrual cycle of another if they exist together for a long time.This is often seen on women’s sports teams or shared dorms. What explains this fact is not completely clear. We can only say that menstrual cycle , although a clear mechanism, but can change significantly in a normal healthy woman and these changes are a reflection of the body’s response to external and internal factors.
Menstrual cycle is not always stable
The most irregular period is the first two years after the onset of menstruation and three years before the end (menopause).Disturbances during these periods are due to completely physiological reasons, which we will discuss below.
Where do these numbers come from and why can they change?
The menstrual cycle is divided into three phases: menstruation, the first phase (follicular) and the second phase (luteal). Menstruation lasts an average of 4 days. During this phase, the lining of the uterus (endometrium) is rejected due to the fact that pregnancy has not occurred.
The first phase lasts from the end of menstruation to ovulation, that is, on average, up to 14 days of the cycle with a 28-day cycle (the days of the cycle are counted from the start of menstruation).
This phase is characterized by the following events: several follicles begin to grow in the ovaries (from birth, a lot of small bubbles (follicles) are laid in the ovaries, in which eggs are located). In the process of their growth, these follicles secrete estrogens (female genital hubbubs) into the bloodstream, under the influence of which the mucous membrane (endometrium) grows in the uterus.
Shortly before the 14th day of the cycle, all the follicles, except one, stop growing and regress, and one grows on average up to 20 mm and bursts under the influence of special stimuli.This process is called ovulation. An egg cell comes out of the burst follicle and enters the fallopian tube, where it waits for the sperm. The edges of the ruptured follicle collect (like a flower that closes at night) and now this formation is called the “corpus luteum”.
Immediately after ovulation, the second phase of the cycle begins . It lasts from the moment of ovulation to the onset of menstruation, that is, about 12-14 days. During this phase, the woman’s body waits for the onset of pregnancy. In the ovary, the “corpus luteum” begins to flourish – the corpus luteum formed from the bursting follicle grows with blood vessels, and begins to secrete another female genital hubbub (progesterone) into the blood, which prepares the uterine mucosa for the attachment of a fertilized egg and the beginning of pregnancy.If pregnancy has not occurred, then the corpus luteum is sent a signal about this and it turns off its work.
When the corpus luteum stops secreting progesterone, a signal is sent to the uterus, and it begins to reject the already unnecessary endometrium. Menstruation begins.
With different cycle times, the duration of the phases is reduced – this means that one woman needs 10 days for the follicle to mature, while the other needs 15-16.
Having dealt with what the menstrual cycle consists of, it is easy to understand what determines its duration in the norm and in the presence of pathology.
Why at the very beginning everything is often not stable and then, after childbirth, it gets better?
A woman’s reproductive system matures gradually, and being a complex mechanism, requires a period of adjustment. The fact that a girl has her first menstrual period as early as does not mean that her system has matured and is ready to work fully (although for some, the menstrual cycle begins to work correctly from the very beginning).
The functioning of the female reproductive system can be best compared to an orchestra, the well-coordinated playing of all the instruments of which creates a unique sound of a piece of music – in our case a regular menstrual cycle. Just as the instruments in the orchestra need a period of tuning, so all the components of the reproductive system need to agree with each other about understanding and working together harmoniously. Such a rehearsal usually takes about 6 months – some have more, some have less, and some may take longer.
Why are there delays or why my periods start earlier?
Everything is very simple – if during the first phase of the cycle it is not possible to grow a full-fledged follicle that could burst in the middle of the cycle (ovulation), then the second phase of the cycle, accordingly, does not begin (no ovulation – there is nothing for the corpus luteum to form).The first phase lasts a long time, until the lining of the uterus (endometrium) that has overgrown under the influence of estrogen begins to be rejected on its own (like a pyramid of cubes collapses when it is kept too high). The cycle in this situation can take up to several months.
In this case, in the next cycle, ovulation can occur and the cycle can have a normal length. When this alternation occurs, they speak of an irregular menstrual cycle.
Another reason for delayed menstruation may be too long existence of the corpus luteum. As I noted above, it lives for about 10 days and then begins to curtail its work, since the pregnancy did not occur. But sometimes it happens that, despite the fact that pregnancy has not occurred, the corpus luteum continues its work and menstruation does not occur in any way, and it occurs only when the corpus luteum finally decides to leave.
More than earlier onset of menstruation is associated, as a rule, with the fact that also the notorious corpus luteum, on the contrary, stops working too early.This leads to an earlier onset of menstruation.
Remember how the orchestra sounds when tuning the instruments – this is the same cacophony from the menstrual cycle is often observed at the beginning. The components of the reproductive system agree between them so that they can grow a follicle in 14 days, start the ovulation process, and maintain the corpus luteum for at least 10 days. At the beginning, she does not succeed in all stages of this work, and this is manifested by an irregular menstrual cycle.
But this adjustment can be very seriously interfered with by the person himself.Nothing negatively affects the process of the formation of the reproductive system as stresses (intensive studies, exams, unhappy love), intensified sports training, extreme weight loss, frequent illnesses, smoking, alcohol and drugs. Against the background of all of the above, quite often menstruation disappears and then they have to wait for a long time. And the reason is very simple, I would say there is a simple biological expediency in this – in extreme living conditions and when, for health reasons, a woman cannot bear healthy offspring – the reproductive function is turned off until better times.Not for nothing during the war, most women stopped menstruating, this phenomenon was even given a special term “wartime amenorrhea.”
What to do about it?
I will make a reservation right away that I do not take into account various diseases, I am talking about some common problems of adjusting the menstrual cycle. Such violations of the cycle are solved by taking hormonal contraception. Here we need to return again to the comparison with the orchestra. If the orchestra begins to out of tune, you must completely stop the game, give the musicians a rest and start over.Hormonal contraception does just that. She turns off the reproductive system and all the time she is taking contraception, she “rests”. Then, after its cancellation, the system starts working again and, as a rule, cycle failures pass.
Why is it quite often after childbirth that the cycle becomes stable and sexuality flourishes?
The orchestra can rehearse as long as it wants, but it is finally played only when it performs its first concert from beginning to end. Pregnancy is the only purpose for which the reproductive system is provided for in the body. Only after the first full-fledged pregnancy, ending with childbirth and the period of breastfeeding, the reproductive system matures fully, since during this period all the functions provided by nature are realized. After pregnancy, a woman finally matures and all the incompletely “unpacked” properties of the body finally begin to work in full force.
The reproductive system must be used as intended – this is important; menstruation is not a function of the reproductive system, but a monthly reminder that it exists at all and while it works.
Step 30 …
As time goes on, the reproductive system, which, on average, is assigned to exist in a working condition for 38 years (from 13 to 51) instead of performing its function is limited only to regular menstruation.
For information: , on average, a woman per life (with 2 births) experiences about 400 menstruation and loses about 32 liters of blood, while with reproductive behavior (pregnancy, childbirth, 3 years of feeding, and only then 1-2 menstruation and again pregnancy) menstruation is about 40.
In addition, with age, a woman’s history of various gynecological and general diseases is replenished, and all this begins to affect the state of the reproductive system and, therefore, is reflected in menstrual irregularities. Inflammation, abortion, gynecological surgery, overweight or underweight, common chronic diseases can cause problems.
Violation of the menstrual cycle in the form of delays or earlier onset of menstruation a couple of times a year can occur in the absence of any pathology.
As a rule, this is associated with climate change or other stresses for the body (illness, hard work, personal problems, etc.). All nervous professions can lead either to delayed menstruation, to their earlier onset, or to complete cessation.
All women are different, so everyone will have different cycles depending on the type of stress response and the phase of the cycle in which it occurs. For most women, nervous work does not affect their menstrual cycle at all. Violations of cycle , especially if it was previously stable, often make a woman think that something is wrong with her. It is not always necessary to panic.
If you can clearly remember any negative events in the recent past that greatly shocked you, then most likely all this violation of the cycle is one-time and there is nothing wrong with that. If there is no menstruation for a very long time (and the pregnancy test is negative), then you need to see a doctor. If menstruation came earlier and does not end in any way, this is also a reason to hurry up for an examination with a gynecologist.
Sometimes a violation of the cycle can manifest itself with very frequent menstruation (several times a month). And then there is no need to delay – urgently see a doctor.
But if the regularity of the cycle disappears completely – this is also a reason to consult a doctor.
Regularity is the main indicator of the normal functioning of the reproductive system. Sometimes it happens that the cycle had one duration and suddenly becomes shorter while maintaining its regularity. As a rule, this is due to the fact that the second phase of the cycle becomes shorter, since the corpus luteum begins to work less.Such changes are more often observed closer to 40 years. This is not a cause for panic, but simply a reflection that your reproductive system will change as you age as you do.
This is one of the most common fears among women. In fact, this fear is exaggerated, since early menopause is quite rare . It is mainly caused by rare congenital diseases, rare systemic diseases, the consequences of treatment (chemotherapy, radiation therapy for cancer) and other rare conditions.There are situations when, as a result of surgery, a woman’s ovary or part of it is removed. Then menopause may occur earlier due to the fact that there is little tissue left in the ovaries that could support the normal functioning of the reproductive system.
Early menopause, , as a rule, is manifested by the cessation of menstruation and the appearance of symptoms of insufficiency of female sex hormones (hot flashes, irritability, tearfulness, insomnia, etc.) There is no prevention of this disease.
Painful periods and PMS
For some reason, it is generally accepted that feeling unwell during menstruation is normal. Pain, nausea, migraine during menstruation is not normal. This condition of painful menstruation is called dysmenorrhea and requires treatment. Even if these phenomena are insignificant, they can and should be corrected.
Dysmenorrhea occurs as primary (most often at a young age), when it is most likely due to simply immaturity of the reproductive system and secondary – when it is a reflection of a number of serious gynecological diseases .
The same applies to premenstrual syndrome. In general, the widespread popularization of this syndrome allows women to write off their sometimes not entirely adequate actions and behavior on the manifestations of this syndrome. However, PMS is not a woman’s personality trait that everyone has to put up with. PMS is a disease that has not fully understood causes, a whole list of symptoms and specific treatment measures. PMS manifestations can and should be corrected. It is wrong to take monthly illness for granted in modern conditions.If you have such problems, see your doctor.
How it all ends
The extinction of the reproductive system usually occurs in the same way as its formation. Menses become irregular and tend to be delayed. This is due to the same reasons as in the beginning.
The ovaries respond worse to stimuli from the brain. It is impossible to grow follicles that could achieve ovulation – the cycle is accordingly delayed.If ovulation occurs periodically, then the formed corpus luteum does not work well. Because of what, periods either start earlier or vice versa are delayed for a long time. Eventually, menstruation stops, and if there is no more than 6 months, you need to see a doctor. Based on hormonal tests and ultrasound, the onset of menopause can be assumed.
Sometimes there are cases when menstruation stops for a long time , and the onset of menopause is assumed by tests and ultrasound.This can especially scare women at a young age. However, this may only be a temporary period, and menstruation may resume on its own, for example, after a good rest.
Thus, the myth that 28 days is the norm and everything that differs from this figure is pathology has been debunked. The main thing in the menstrual cycle is its regularity, and the duration of the cycle can fluctuate over a wide range.
And yet, there is a simple rule, if you regularly undergo a preventive examination by a gynecologist (at least once a year), in case of any violations, do not postpone an “unpleasant” visit to the gynecologist – then you will almost never have serious gynecological problems …
90,000 Reasons for delayed menstruation with a negative pregnancy test
Possible causes of delayed periods
Problems with the menstrual cycle can occur in women at any age. Why is there a delay in menstruation with a negative pregnancy test? Each gynecologist will answer that this indicates some kind of disturbance in the work of the body, and this may be due not only to the reproductive system.
Possible reasons for a delay in menstruation
During normal body functioning, a woman’s menstrual cycle lasts 21-30 days. How many days can there be a delay in menstruation in the norm? Gynecologists say that a week of delay in the absence of pregnancy is a reason for a full examination. Such a failure in the menstrual cycle does not pose a threat to health, although in the first days of the delay, the woman will feel discomfort. Many people note that even in the absence of pregnancy, they experience discomfort in the mammary glands and abdomen.Why does the chest hurt and the lower abdomen hurt against the background of the absence of pregnancy and a short-term delay in menstruation? Only a doctor can give a competent and informative answer to this question, since pain can be associated with the growth of a benign tumor, and with problems in the hormonal system.
In general, doctors single out the possible reasons for the delay in menstruation in a separate list:
- weight disorder – obesity of 2-3 degrees of severity, lack of weight;
- rigid diet;
- emotional “bursts”, stressful situations;
- inflammatory processes in the internal genital organs;
- infectious diseases of an acute or chronic nature.
In addition, a woman’s body can react with a disruption in the menstrual cycle to a sharp change in climate, prolonged use of hormonal contraceptives. Many women are interested in whether there can be a failure of menstruation after taking antibiotics – yes, this is quite likely. After all, any interference with the work of the body (even if it is performed with good intentions) provokes stress, the functionality of organs and systems is disrupted. Of course, if the intake of antibiotics lasted 5-7 days, then this cannot be the reason for the delay in menstruation, but with a long course of therapy (15-20 days), it is quite possible.
Delay in hormonal disorders
The main reason for the delay in menstruation in the absence of pregnancy is hormonal disorders. And they can occur in the background:
- start taking hormonal contraceptives;
- abrupt withdrawal of oral contraceptives;
- progressive uterine fibroids;
- the presence of malignant neoplasms.
Hormonal delay in the menstrual cycle in adolescents is normal and does not require any treatment.The fact is that in adolescence, the menstrual cycle is just beginning to stabilize, at the same time the body grows and the secretion of hormones increases. These changes lead to a delay in menstruation.
How to solve the problem
Many women are interested in how to cause menstruation when they are delayed. There really are such specific means, but it is strictly forbidden to take them on your own! Firstly, the woman herself will never find out the true reason for the delay in menstruation – this is the work of a gynecologist.Secondly, you need to know the dosage of drugs so as not to provoke uterine bleeding. Thirdly, even if a pregnancy test shows a negative result, this does not mean 100% no conception.
What if there is a big delay in menstruation? You need to seek qualified medical help, undergo an examination and only after that take some medical measures. As part of the diagnosis, gynecologists prescribe to patients not only laboratory tests of blood and smears from the vagina / cervical canal, but also instrumental examination.An ultrasound scan will be quite informative – the doctor will be able to see either pregnancy, which does not show up in any way on tests, or a tumor in the uterine cavity. And a blood test for hormone levels will help establish the exact cause of menstrual irregularities.
If your period is delayed by more than a week, then this is a cause for concern. Unfortunately, many women do not pay attention to such violations and do not visit a gynecologist, and this can lead to serious consequences.