Is Prolonged Menstrual Bleeding Cause for Concern?

As if the inconvenience and pain of a regular period weren’t bothersome enough, some women experience prolonged menstrual bleeding for some or all of their cycles.

You might find yourself bleeding for five, six, or even seven days, wondering when it will end and you can get back to those white pants or light-colored bathing suits.

While most of the time lengthy period bleeding is normal, it can be an indicator of a number of medical conditions, including, rarely, cancer, says Jackie Thielen, MD, an internist and director of the women’s health specialty clinic at the Mayo Clinic in Jacksonville, Florida. That’s why it’s important for a woman whose bleeding is excessive or prolonged to consult with her physician, she says.

RELATED: Is Your Period Normal?

Doctors use the term “menorrhagia” to describe a period that is dangerously heavy or long-lasting. According to the Mayo Clinic, menorrhagia means more than just having a period that drags on longer than you’d like; it means you are losing so much blood through your menses that you can’t maintain your usual activities.

What Is the Normal Duration for a Menstrual Period?

Women vary greatly in the range of their cycles. This includes how long they go between periods (typically anywhere from 21 to 35 days).

It also includes how long a period lasts. Generally, a period should last six days or less and start heavier and get lighter. “But every woman is different,” Dr. Thielen says.

RELATED: Why Anxiety Spikes With Your Period

What’s more important is whether the length of your period has changed, she stresses. “If you regularly bleed for eight or nine days, that’s not concerning. But if you previously had a five-day flow and now you’re going eight or nine, that should be evaluated,” she says. Even women in perimenopause, whose periods may be all over the place, are wise to get examined if the length of their period changes markedly.

Depending on the circumstances, long menstruation might be a mild condition that can be easily controlled, or one that indicates a more serious underlying health issue.

Is It Normal for a Period to Not Stop?

For some women it may seem as if the bleeding literally doesn’t stop, continuing through the entire month. But this isn’t usually the case.

Since the time between cycles is counted from the first day of your period, a woman who has a 24-day cycle with eight days of bleeding will experience only 16 days period-free. It may seem like you’re always having your period even though you’re within a standard timetable.

What Causes Prolonged Menstrual Bleeding?

While irregular menstrual periods can be bothersome, many are caused by hormonal changes, which are common and rarely mean something serious. Younger girls just entering puberty and older women approaching menopause are most likely to experience these hormonally based prolonged or irregular periods.

Usually, a changing level of estrogen is to blame. Estrogen helps build up the uterine lining, called the endometrium, which if it is fertilized will support a pregnancy. If no pregnancy happens that month, the lining is shed as a menstrual period. Doctors use the term dysfunctional uterine bleeding (DUB) when a hormone imbalance is the cause of the bleeding.

In some cases, birth control can impact the frequency, duration, and flow levels of menstrual periods. The copper IUD may cause extra bleeding, Thielen says. And while birth control pills usually shorten your periods, it’s possible some can have the opposite effect. Changing the type of birth control you use may help with this issue. But if you are on birth control pills you should not stop taking them or alter your birth control strategy without speaking to your physician.

What Underlying Conditions May Cause Prolonged Menstrual Bleeding?

A visit with your gynecologist or other healthcare professional is the first step in determining the cause of your prolonged menstrual bleeding. Your doctor will make a diagnosis after performing a series of tests.

Depending on your age and other symptoms, your doctor may test your blood for pregnancy, hormone levels, and thyroid function. Other diagnostic tests may include Pap smears, endometrial biopsies, ultrasounds, laparoscopic surgery, or other procedures.

A wide range of medical conditions can be the cause of abnormal menstrual bleeding. These include:

• Uterine fibroids These noncancerous growths emerge inside the uterine walls. They can range in size from one tiny speck to several bulky masses. Also called leiomyoma, uterine fibroids can lead to heavy bleeding and periods that last longer than a week.
• Uterine polyps These small, noncancerous growths appear on (not inside) the wall of the uterus. Polyps are usually round or oval shaped.
• Endometriosis With this disorder, tissue similar to the type that lines the inside of your uterus abnormally grows outside your uterus, sometimes extensively. In addition to excessive bleeding, endometriosis can cause significant pain.
• Endometrial hyperplasia This is a condition in which the lining of the uterus, called the endometrium, becomes too thick. An excess level of the hormone estrogen is often to blame.
• Polycystic ovary syndrome (PCOS) PCOS is a hormonal disorder that often includes excess levels of the male hormone androgen.
• Thyroid disease Unhealthy levels of your thyroid hormone can cause periods to be long, heavy, light, or irregular.
• Intrauterine device (IUD) Especially in the first year, a copper IUD can cause heavier menstrual bleeding.
• Pelvic inflammatory disease (PID) PID is an infection in the female reproductive organs that is often transmitted during sex.
• Bleeding disorders When the blood does not clot properly, it can cause heavy menstrual bleeding.
• Endometrial cancer Though rare, this cancer of the uterine lining is the most serious cause of prolonged menstrual bleeding.

What Treatments Are Available for Prolonged Menstrual Bleeding?

Many causes of prolonged bleeding can be treated with birth control pills of estrogen and progesterone. This not only provides contraception, it can regulate hormone production and so treat bleeding caused by hormones. “Birth control pills generally decrease the overall amount of flow and so should lessen the length of your period,” Thielen says.

In some cases, such as for endometrial hyperplasia, the hormone progestin may be prescribed alone.

Other medicines may also be used. Lysteda (tranexamic acid) is a prescription drug that treats heavy menstrual bleeding. It comes in a tablet and is taken each month at the start of the menstrual period.

Prolonged bleeding caused by uterine fibroids can be treated with medication or with minimally invasive procedures such as endometrial ablation, uterine artery embolism, or laparoscopic surgery (known as a myomectomy). In severe cases an abdominal myomectomy or a hysterectomy may be recommended.

Treating endometriosis can be challenging. Surgery to remove the unwanted lesions seems to provide the most long-last results.

Are There Any Complications From Having a Long Menstrual Period?

Often, the biggest problem from having a long menstrual period is the way it impacts your quality of life. If this is the case, don’t be shy about exploring ways to change your cycle with your doctor.

“It’s okay to treat something simply because it’s a bother. Women don’t have to live that way,” Thielen says

And since blood is rich in iron, women who bleed a lot are at risk of anemia, she says. Talk to your doctor about whether you might need iron supplementation, and what schedule you should take it on. A study by Indian researchers published in December 2019 in the Annals of Hematology found that women taking 120 mg of iron every other day reached the same blood levels after six weeks as women taking 60 mg daily, with the alternate-day dosing causing less nausea.

How Can Birth Control or Menopause Affect the Duration of Your Period?

Birth control pills generally help with prolonged menstrual bleeding, but on occasion may cause it. IUDs, especially copper IUDs, sometimes cause prolonged bleeding, especially in the first year after insertion.

Women in perimenopause, the years leading up to menopause, frequently find their periods changing. Still, even if you’re perimenopausal, you want your doctor to check things out. “Long or irregular bleeding may just be from perimenopause. But it is also often our first clue of endometrial cancer or cervical cancer,” she says.

RELATED: Perimenopause versus Menopause: What’s the Difference?

When Should You See a Healthcare Professional for a Long Menstrual Period?

If you have a long period for only one month, there’s probably no need to worry. But “if you notice a change for two or three cycles, that’s the time to seek out your doctor,” Thielen says.

Any significant bleeding (as opposed to spotting) between periods without an explanation such as a recently placed IUD should be evaluated. And a woman past menopause should have no bleeding at all and so should see her doctor immediately if she does.

Which Healthcare Professionals Can Help?

Several different types of medical professionals can help with prolonged periods. These include:

• Primary care physician
• Gynecologist
• Nurse practitioner
• Physician assistant
• Interventional radiologist

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Causes, When to Seek Help, Treatment, and More

If you experience periods that last longer than seven days, see your doctor. It may be a sign of a serious underlying health condition that needs to be addressed.

Generally, a period lasts between three to seven days. A menstrual period that lasts longer than seven days is considered a long period.

Your doctor may refer to a period that lasts longer than a week as menorrhagia. You may also be diagnosed with menorrhagia if you experience unusually heavy bleeding that lasts less than a week. Five percent of women have menorrhagia.

A long period may be a sign of a serious underlying health condition, such as:

• hormone irregularities
• uterine abnormalities
• cancer

It’s important to see your doctor if you experience a long or heavy period so they can identify the underlying cause or rule out more serious possible causes.

Menorrhagia can cause discomfort during your period as well as disrupt your regular routine. You may find that the bleeding affects your activities or your sleep. You may also experience iron deficiency anemia if you regularly experience long menstrual periods, especially if they’re heavy.

Read on to learn more about long periods, including possible causes and what you can do to manage this symptom.

Long periods can be caused by a wide range of underlying conditions.

Hormone and ovulation changes

Changes to your hormones or ovulation may cause a long period. You may notice hormonal changes when you first get your period during puberty or in perimenopause. You may also experience a hormonal imbalance from different health conditions, such as thyroid disorders or polycystic ovary syndrome.

If your hormones aren’t at a normal level or if your body doesn’t ovulate during your menstrual cycle, the uterine lining can become very thick. When your body finally sheds the lining, you may experience a period that’s longer than normal.

Medications

You may experience long periods because of medications you take. These can include:

• contraceptives, such as intrauterine devices and extended birth control pills
• aspirin and other blood thinners
• anti-inflammatories

Pregnancy

While not actually a period, extended vaginal bleeding may be a sign of an unsafe or nonviable pregnancy, such as an ectopic pregnancy or a miscarriage.

You may also have extended bleeding in pregnancy if you have a condition like placenta previa.

If you’ve had a pregnancy test come back positive and you’re experiencing vaginal bleeding, see your healthcare provider.

Uterine fibroids or polyps

Uterine fibroids and polyps can lead to extended, and sometimes heavy, bleeding.

Fibroids occur when muscle tissue begins to grown in the wall of the uterus.

Polyps are also the result of irregular tissue growth in the uterus and cause small tumors to grow.

Generally, neither fibroids or polyps are cancerous.

Adenomyosis

Adenomyosis is another type of tissue buildup. The condition occurs when your endometrium, or uterine lining, embeds itself into the muscles of your uterus. This can lead to a long or heavy period.

Thyroid condition

You may have a long period if your thyroid is underperforming. This condition is known as hypothyroidism.

Bleeding condition

You may have a condition that affects your body’s ability to clot blood, causing your long periods. Two of these conditions are hemophilia and von Willebrand’s disease.

A long period may be the only sign of one of these conditions, or you may have other symptoms.

Obesity

Excess weight may cause long periods. That’s because fatty tissue can cause your body to produce more estrogen. This excess estrogen can lead to a change in your period.

Pelvic inflammatory disease

Pelvic inflammatory disease (PID) occurs when bacteria infect your reproductive organs. In addition to changes to your menstrual cycle, PID can also lead to abnormal vaginal discharge among other symptoms.

Cancer

A prolonged period may the sign of cancer in your uterus or cervix. For some women, this may be one of the earliest symptoms of either of these cancers.

Don’t ignore a long period. It’s important to see your doctor to discuss why you might be experiencing this symptom. Delaying your diagnosis and treatment could lead to a worsening of the underlying condition responsible for the extended bleeding.

You may want to seek immediate care with a long period if you spike a fever or are losing an abnormally heavy amount of blood or large blood clots. A sign that you’re losing a lot of blood is if you need to change a pad or tampon one to two times per hour for several hours. You may also begin to feel lightheaded if you’re losing a lot of blood.

There are many causes for a long period, so your doctor will likely begin your appointment by asking you some questions. These may include:

• when your period started
• how many pads and tampons you’ve used in the last day
• your sexual activity
• other symptoms you’re experiencing
• your medical and relevant family histories

They may also do a physical exam that includes a pelvic exam and measuring your vital signs.

Your doctor may also recommend any of the following tests to help them make a diagnosis:

• blood tests to check hormone levels and also to look for signs of an iron deficiency
• pap smear
• biopsy
• abdominal or transvaginal ultrasound
• hysteroscopy
• dilation and curettage

Treatment methods for a long period can vary. Your doctor will treat the underlying cause. They may also recommend a treatment to reduce your current bleeding, regulate your period, or relieve any discomfort.

Hormonal birth control may regulate your period and shorten it in the future. This medication can be administered as:

• a pill
• an intrauterine device
• a shot
• a vaginal ring

Your doctor also may advise you to take medication that reduces pain or discomfort you experience from the prolonged period. These medications may include over-the-counter nonsteroidal anti-inflammatories, such as Advil or Motrin.

In some cases, your doctor may recommend a surgical procedure to alleviate long periods.

Dilation and curettage can thin the layer of your uterus and reduce how much you bleed during your period.

If you’re no longer considering having children, you may undergo endometrial ablation, resection, or a hysterectomy. These procedures can relieve the long periods, but they may also eliminate the possibility of getting pregnant.

Delaying a diagnosis could result in a more invasive procedure or intensive treatment for the underlying cause.

Additionally, if your long period causes heavier blood loss, you could be at risk of developing anemia. This may contribute to feelings of tiredness and weakness.

Your doctor can use results from a blood test to diagnose anemia. If your iron levels are low, your doctor may recommend boosting your diet with iron-rich foods and a possible iron supplement to get your levels back to normal.

Long periods may also be painful and interfere with your well-being and quality of life. You may miss days of school or work, or withdraw from activities you enjoy because of your long period.

There are many reasons you may have a period that’s longer than normal. Long periods can get in the way of your normal life, and they may also be a sign of an underlying condition that requires treatment.

See your doctor to find out the cause of your long period so you can begin to treat it. Delaying treatment may cause complications and lead to more invasive treatments in the future.

signs that you no longer have feelings for your partner

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It seems to you that feelings have cooled down. A dilemma arises: did your story come to an end, or did you make it all up? You just move with it by inertia. Or you simply were not ready for the fact that after the candy-bouquet period, a measured and predictable life begins. How to understand that she really fell out of love with a guy, and what should be the signs for this? VOICE will help you understand the problem and eliminate the error.

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Love

relationship problems

truth or myth

Relationship with husband

“It seems that there are no former feelings between us anymore,” every girl uttered such words at least once in her life. Sometimes it seems to you that everything is over, and not a drop of love is left. And it no longer looks like a bad mood after a quarrel or a bad day. But how to determine that the fading is actually happening and these are not temporary difficulties?

Do not self-medicate! In our articles, we collect the latest scientific data and the opinions of authoritative health experts. But remember: only a doctor can diagnose and prescribe treatment.

Myth: “He started to annoy me”

True:

There is not a single person on earth who would not be annoyed by the permanent presence of another. You live with him or see him almost every day. Yes, if he were a friend, you would have climbed the wall a long time ago from some little things like slurping tea or socks scattered around the apartment.

Solution:

Very often the cause of your irritation is not the man himself, but something deeper and more personal. For example, it’s not the mess itself that pisses you off, but “hello” from your parents who punished you too aggressively for disobedience when you didn’t want to clean the room. The same applies to other everyday habits that annoy you so much.

As soon as he starts to infuriate you, it is impossible to immediately understand that you have already stopped loving the person. If you are able to analyze and realize this, the solution will be at your fingertips. It is much easier to invite a housekeeper than to sort things out on a domestic basis. But if there is more negative in any aspect than positive, this is a good reason to think.

ADVERTISING – CONTINUED BELOW

Myth: “We have become like brother and sister”

True:

With a strong rapprochement, as if you have become relatives, there is a desire to understand if you have fallen out of love with a person. Or your passion has not grown into sisterly and brotherly feelings. Psychologists believe that friendships filled with mutual understanding are just the foundation for a long-term romance. It’s all about the feeling of gratitude and unity experienced by a couple who know how to be comrades to each other. It helps out a lot when the main passions subside.

Solution:

Remember that it was your “brother” boyfriend who was there when you needed him most. You got things done together, acting like a well-functioning team. From these thoughts it becomes warm, and you can feel tenderness for your so close and familiar man.

Myth: “There is no emotional intensity in our relationship”

True:

…And that’s okay. After all, the amount of hormones and neurotransmitters in the blood of lovers in the acute stage is off scale. And this means that you would not be able to work, sleep, eat, communicate with friends, live, all thoughts about him and him … Therefore, nature provides for a certain decline after a certain period of living together. But in the future, cyclical rises will follow: for some, after a year, and for other couples, every 3-4 years. By the way, a new emotional outburst is provoked by significant events in your life.

Solution:

The signs by which you can really understand that you have stopped loving your husband will be the following: you want to stay at work as long as possible and not listen to his conversations. Total indifference set in, you squeezed everything you could out of these relationships, and you need to think about the meaning of the continued existence of this union. And if the passion just subsided, this does not mean at all that there are no more feelings. She will return if she fills her life with new impressions.

How to forget a loved one

They say that extreme sports are good for this (because many people mistake an adrenaline rush for sexual arousal), romance (because feelings need a special atmosphere), new impressions (then you just change the scenery). But there is a real danger – to turn a good relationship into a continuous drama in order to squeeze at least a drop of emotion out of them.

Myth: “I have already begun to look at others”

True:

Man, unlike the swan, is a polygamous animal. But monogamy, as anthropologists have found out, is a social phenomenon, forced, provided in order to protect their territories and bring food with great success. Therefore, there is nothing strange in the fact that your fantasies project an interest in other young people. Unfortunately, this also applies to your boyfriend.

Decision:

To change or not is a purely personal matter for everyone. Psychology explains how, in case of such doubts, to understand that you have fallen out of love with your chosen one. Unlike other polygamous animals, our sexual appetite is controllable and our temperament is well logical.

How to make a man fall in love with you

You don’t want to restrain your appetite, but you are cold towards your missus, it seems that this is the finale. And if the matter is limited to the imaginary satisfaction of “hunger” on the side, but in reality you want to make love only with him, this is another matter. Unleash your fantasies with your missus and surprise him with a burst of passion. He will probably appreciate it.

By the way, there are so-called “psychological monogams” in nature. There are very few of them, but such people do not want anyone other than a chosen partner. It is believed that if two such people come together, there will be no limit to their happiness.

Myth: “Sex is not the same anymore”

True:

We “addict” to sexual partners like a drug. It’s all about the hormone oxytocin, which is responsible for feelings of tenderness and trust for each other. Another thing is that it may turn out that your current partner is not so compatible with you in bed, like a half-forgotten university womanizer.

How to understand that a man loves you

And this makes you think that your sex life has deteriorated. How to understand if you have fallen out of love with your prince if there is complete calm in bed and you involuntarily begin to compare him with others?

Solution:

Compromise is the basis of any relationship, from work to love. If he wants less than you, or you prefer rudeness to his trademark “vanilla” caress, you can always negotiate. Let today everything be as he wants, and tomorrow – according to your wishes. By the way, sexologists once again proved that true sexuality is revealed only when you and your partner have spent more than one month together. So, it is quite possible that everything is still ahead of you.

Love is gone: objective indicators

1. Everything is too emotional. The game of “hot-cold”, constant scandals, disappearances, reconciliations and confessions are more like a love addiction than true love.
2. You experience psychological discomfort with him. This can be expressed in a sense of one’s own inferiority next to him, complexes, fears of loss, fear of being abandoned. As a rule, it is not mutual attraction that leads people into such relationships, but their own complexes. Which, alas, rarely develop into a true feeling.
3. When a relationship is at first glance harmonious and ideal, it is very difficult to understand that you have stopped loving him, as well as to stop your dependence on them. It doesn’t matter if it’s psychological, physical or material. Without it, you feel better. Maybe there was something valuable and important, strong and deep between you, but, unfortunately, it has exhausted itself. In this scenario, a breakup can make you happy and free.

Text: Daria Mazurkina

“There are always good reasons not to do anything, especially not to do anything yourself” – Weekend

On April 24, 1953, Queen Elizabeth II conferred a knighthood on British Prime Minister Winston Churchill; which upheld the highest human values. Churchill really went down in history as a great orator, able not only to change history with the help of words, but also to clothe what is happening in such formulations that do not lose their relevance even decades later.

Winston Churchill watching the military action near Florence, August 20, 1944

Photo: Capt. Tanner/Imperial War Museums/Getty Images

Winston Churchill watching the fighting near Florence, 20 August 1944

Photo: Capt. Tanner / Imperial War Museums / Getty Images

1
I have a rule that when I am abroad I never criticize or attack my government. But I make up for lost time when I return.

“Empire and Freedom” speech, April 18, 1947

2
I am generally an optimist. I don’t see much point in being someone else.

Speech at the lord mayor London banquet, November 9, 1954

3
I have no doubt that the Romans made plans for a day better than us. They got up before dawn in all seasons. We never see the dawn, except in wartime. Sometimes we see the sunset. Sunset means sadness, dawn means hope.

My Early Years, 1930

4

“Foreign Policy”, November 17, 1949

5
A statesman who succumbs to military fever must understand that if he gives the appropriate signal, he will cease to be the master om of the situation and will become a slave to unpredictable and uncontrollable events .

My Early Years, 1930

6
No matter how confident you are in your victory, always remember: there would be no war if your opponent did not think what he also has chance to win.

My Early Years, 1930

7
Art without tradition is a flock of sheep without a shepherd. And without innovation – a corpse.

Speech at the Royal Academy of Arts, 1953

8
Truth is immutable. Panic may hate her, ignorance may mock her, malice may pervert her, but she will remain herself.

Royal Assent Speech, May 17, 1916

9
Looking too far is a mistake. At one moment in time, you can control only one link in the chain of fate.

Speech “Crimean Conference”, February 27, 1945

10
Generally speaking, short speeches are better. And old speeches, when they are also short, are best.

The London Times Literary Prize Speech, November 2, 1949

11
As for me, I am always ready to learn, even though to the fact that I don’t always like being taught.

Debate in the House of Commons, November 4, 1952

12
I am absolutely convinced that if we begin to clarify the relationship between the past and the present, we will lose the future.

Speech “Their Star Hour”, June 18, 1940

13
The principle “if done, you can do it perfectly shorter:“ paralysis ”.

“Second World War. Part 4, 1950

14
I have always believed that a politician should be judged by the aggression he arouses in his opponents. I strove not only to cherish their rage, but also to do everything to deserve it.

Speech at a dinner at the Institute of Journalists, November 17, 1906

15
ika. On his deathbed, he said that he had a lot of anxiety in life, but most of it about what never happened.

“Second World War. Part 2, 1949

16
The inherent vice of capitalism is the unequal distribution of goods. The inherent virtue of socialism is the equal distribution of suffering.

Speech in the House of Commons, October 22, 1945

17
th life. Five years is a lot. Twenty years for most people is the maximum that can be surveyed. Fifty is ancient. To understand how the course of history influenced the people of this or that generation, you need to imagine their situation, and then transfer its duration to the timeline of your own life.

History of the English-speaking Peoples, 1956

18
I categorically refuse to be impartial in the relationship between the fire brigade and the fire.

Debate in the House of Commons, July 7, 1926

19
Broadly speaking, people can be divided into three classes: those who work to death , those who are worried to death, and those who are bored to death.