Menopot
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Prolonged Menstruation

Prolonged Menstruation

On an average, menstrual flow occurs every 28 days and lasts about 4 days. A small percentage of women have periods more often than every 21 days or less often than every 35 days. Though the timing and duration varies with each woman, they are still considered normal as long as it stops within 4 or 5 days.


In general, every woman maintains a menstrual pattern. It can occur roughly at the same date or 2-3 days earlier from your LMP (last month period) each month. However, at certain age, the frequency between periods start fluctuating considerably, making it extremely difficult or even impossible to track.


Prolonged periods last longer than 7 days. You might notice heavy bleeding during this period, say you completely soak through a sanitary pad or tampon every hour for 2-3 consecutive hours. Also termed as irregular period, prolonged or continuous bleeding arises when women do not properly develop and release a mature egg every month, as they should normally. Prolonged and continuous bleeding can cause mood disturbance and can significantly affect quality of life. Do not neglect it.


Types of Prolonged periods

There are different types of irregularity. They are classified based on the various response produced in woman.


Irregular periods affecting frequency of menstruation

Polymenorrhea: Frequent periods with intervals of 21 days or less


Oligomenorrhea: Infrequent or short menstrual periods where frequency exceeds 35 days in between menstruation


Amenorrhea: Absence of periods for more than 60 days in a woman of reproductive age


Irregular periods producing pain during menstruation

Dysmenorrhea: cramps or painful menstruation accompanied by either pain, usually in the pelvis or lower abdomen)


Irregular periods that affect quantity of menstruation

Hypomenorrhea: Decrease or shortening of the duration of menstruation)


Menorrhagia: Heavy or prolonged menstruation associated with abnormally painful period.



Probable causes of Prolonged Menstruation


  • Psychological causes including stress, fear, grief, overexertion, or fatigue that affects the emotional stability and functional balance of the body.

  • Physiological causes like hormonal disturbances that occurs during peri-menopausal.

  • Low levels of thyroid or pituitary function can result in heavy or prolonged period.

  • Low levels of calcium can lead to profuse bleeding

  • Fibroids and cysts

  • Drugs like anticoagulants, steroids, or blood thinners can cause prolonged bleeding

  • Anovulation, (failure of ovaries to produce mature or release eggs)

  • Endometrial (the inner lining of the uterus) polyps

  • Thickening of the uterine wall or Endometrial hyperplasia

  • Endometrial cancer

  • Uterine fibroids

  • Pregnancy complications including miscarriage or ectopic pregnancy, where a fertilized egg implants somewhere other than the uterus

  • Changes in birth control pills or estrogens that you take

  • Use of an intrauterine device (IUD) for birth control

  • Recent trauma, surgery or other uterine procedure

  • Pelvic inflammatory disease or other infection

Tackling prolonged heavy bleeding

Irregular periods or prolonged menstruation caused by anxiety or stress can be treated by taking proper rest coupled with an exercise program. Being overweight or smoking can bring on heavier periods. Avoid aspirin due to its anti-coagulant properties. Typically, NSAIDs are prescribed for pain relief. Oral contraceptives are prescribed to help regulate menstrual cycle and reduce heavy bleeding. In more severe cases, endometrial ablation is resorted to.

You might notice symptoms of anemia such as lightheadedness, shortness of breath, headache and pale skin. Heavy bleeding and pain affects productivity and daily activities. Diagnosis begins with understanding the menstrual cycle patterns and any family history of menstrual issues. Blood and hormonal tests might be suggested. FSH, estrogen and prolactin levels will be examined as also thyroid function. Ultrasound is done to diagnose fibroids, endometriosis, or structural abnormalities. Often alternative therapies such as yoga, meditation and acupuncture are recommended. Herbs such as Black cohosh are suggested.

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