Periods can be a fickle thing for some women, even painful and annoying. And if they last longer than the typical 3 to 5 days, you might be wondering if something’s amiss.
A normal cycle can be anywhere between 21 and 35 days, and bleeding can last for 2 to 7 days. But if there’s a change in cycle length, it can be of concern.
While there is no universal norm, a typical cycle runs for an average of 28 days,1 and the bleeding “period” lasts between 3 and 5 days. But some women have cycles as short as 21 days or as long as 35 days, and their periods may last anywhere from 2 to 7 days. All of these are considered within the “normal” range.
But if you normally have a long cycle and it suddenly shortens, or vice versa, don’t ignore it.2 If you are bleeding heavily for more than 7 days at a time,
1. You May Have Taken Aspirins Or Birth Control Pills
If you don’t usually have heavy bleeding but are suddenly experiencing it, check the medicines you have had recently. Some anti-inflammatory medications and anticoagulants can make bleeding heavier. An example is the popular aspirin.4 Some birth control pills can also cause heavy bleeding.
[Also Read: Breakthrough Bleeding On The Pill]
2. You May Have Given Birth Or Had A Miscarriage
If you just had a baby, it’s perfectly normal to have heavy or prolonged bleeding lasting anywhere from 2 to 6 weeks. If the bleeding is related to childbirth, the blood is bright red at first. It may have small clots of blood. Over time, the color becomes pink and watery.5
Miscarriages can also result in bleeding. This is marked by blood that is brown
3. You May Have Installed An Intrauterine Device
Sometimes, an intrauterine device (IUD) can cause abnormal heavy or continuous bleeding. If this is the case, you may need to have your gynecologist check the device to see if it has shifted or needs to be replaced. Keep in mind that heavy and prolonged bleeding is normal in the first 3 to 6 months after getting a copper IUD. And while periods may not be heavier with hormonal IUDs, they’re usually longer during the first 3 to 6 months. So, if you’ve just started using either of these methods, you probably don’t need to worry.7
4. You May Have Uterine
Uterine fibroids, or growths made of fibrous tissue and muscle, can cause heavy bleeding during periods. They are estimated to affect 20–50% women of childbearing age and about 70% of women by the onset of menopause, black and obese women more so. The good news, however, is that they’re noncancerous.8 9 They also go away on their own, especially after menopause.
However, pay attention if symptoms like long or heavy periods, constipation, and abdominal or lower back pain become unmanageable. The fibroids may need to be surgically removed or shrunken with medication.
5. You May Have PCOS
Up to 10% of women in the US suffer from polycystic ovarian syndrome or PCOS. Besides causing several other health problems, PCOS can lead to heavy or prolonged periods. It can also trigger endometrial hyperplasia, which is an abnormal thickening of the endometrial tisue lining the inside of the uterus beyond a
6. You May Have Polyps
Polyps, or noncancerous growths on the endometrium (uterus lining) or cervix, can cause bleeding between your periods. They can also cause heavy menstrual bleeding.11 While polyps are quite common, the exact incidence is not known since they do not always present symptoms. These are more common closer to menopause. But since polyps have a 5% chance of being cancerous or precancerous, you’ll probably need to have them removed.12
7. You May Have Endometriosis Or Adenomyosis
Endometriosis is a fairly common uterine disorder, affecting about 10% women worldwide. Extreme pelvic pain is the most common symptom of endometriosis, a condition where tissue lining the inside of the uterus starts growing on the outer surface of the uterus. But long periods, heavy bleeding, and bleeding between periods
Adenomyosis is another condition where the endometrial glands begin to grow into the uterine muscle. If you have had any trauma to the uterus, such as a cesarean section, or if you have endometriosis, you have a higher risk of developing adenomyosis. It results in heavy periods, causing similar symptoms to that of fibroids.14
[Also Read: Causes Of Endometriosis And Risk Factors]
8. Your Endometrium May Be Thick (Endometrial Hyperplasia)
If you have prolonged menstrual bleeding without big blood clots, it’s most likely from endometrial hyperplasia. Women with the condition have a thickened endometrium. This is thicker than the usual buildup of tissue before and after a normal period.15
Basically, when your estrogen levels are higher than your progesterone levels, you don’t ovulate. As a result, the body doesn’t get the signal to stop growing the uterine lining, leading to the thickening seen
Hyperplasia can be caused by the following:16
- The external intake of hormones could disrupt the balance of estrogen and progesterone, leading to hyperplasia, especially if estrogen is taken without progesterone.
- Simply being perimenopausal can cause hyperplasia as ovulation doesn’t happen regularly anymore.
- Polycystic ovarian syndrome can cause irregular periods.
- Being overweight is another cause. Excess estrogen is stored in fatty tissue, after all. So if you’re carrying extra fat, that’s a prime place for estrogen to settle.
9. You May Have Defective Blood-Clotting
If you have a platelet function disorder or have von Willebrand disease (VWD), you may find that bleeding lasts much longer than it should.17 In this genetic condition, the von Willebrand factor, a blood-clotting protein, is defective or fewer than normal in number. VWD affects 1% of the American population, making it the most common bleeding-related disorder. Women with the problem have abnormal or heavy bleeding during their period and after childbirth.18
id="11.-other-disorders">10. You May Have Diabetes, Cirrhosis, Or Thyroid Disorders
If you have diabetes, pelvic inflammatory disorder, thyroid disorders, or cirrhosis, you might have menstrual problems and heavy bleeding. To understand if one of these issues is the culprit, you will need to check for symptoms and get tested.19
11. You May Have Cancer
In some cases, cancer could be the cause of abnormal bleeding. For example, endometrial cancer tends to strike women after menopause, but it can also develop in younger women. So, it doesn’t hurt to have a check-up just in case.20 Ovarian, cervical, or uterine cancer can also cause excessive bleeding.21
How Often Does This Happen?
If you normally experience heavy or prolonged bleeding during your period, you may have a bleeding or platelet disorder.22 And if it happens often but not every time? It could be fibroids, polyps, or endometrial hyperplasia. While fibroids cause large blood clots, endometrial hyperplasia does not.23
If you’re trying to treat your menstrual problem, rule out the other disorders first. Watch for symptoms of these conditions and consult a doctor. This way, you can be tested if you suspect something like diabetes or an underactive thyroid. Once you get treatment for these problems, your periods should go back to normal.
When To Visit A Gynecologist
If you have bleeding for more than 7 days or if your period is suddenly prolonged, you may need to check with your doctor.24
After childbirth, it’s important to see a doctor if the bleeding smells bad or comes with fever or chills. You should also be concerned if the blood is bright red after a week or you have lower abdominal pain.25
If you have a high risk of cancer from menopause, family history, or your own medical history, getting screened is super important.
|↑1||Menstrual Cycle. NHS.|
|↑2||Menstruation and the menstrual cycle fact sheet. US Department of Health and Human Services.|
|↑3, ↑17||Heavy Menstrual Bleeding. CDC.|
|↑4, ↑19, ↑21||Menstrual disorders. University of Maryland Medical Center.|
|↑5, ↑25||Heavy periods. NHS.|
|↑6||Miscarriage. American Pregnancy Association.|
|↑7||Intra Uterine Device IUD. New Zealand Family Planning.|
|↑8||Stewart, Elizabeth A., Charlotte Cookson, Ruth A. Gandolfo, and Renate Schulze‐Rath. “Epidemiology of uterine fibroids: a systematic review.” BJOG: An International Journal of Obstetrics & Gynaecology (2017).|
|↑9||Fibroids. UCLA Health.|
|↑10||Polycystic ovary syndrome. NHS.|
|↑11, ↑14, ↑20||What causes heavy periods?. The Royal Women’s Hospital Victoria Australia.|
|↑12||Endometrial polyps. US National Library of Medicine.|
|↑13||Endometriosis. American College of Obstetrics and Gynecologists.|
|↑15, ↑23||Endometrial Hyperplasia. Hers Foundation.|
|↑16||Endometrial Hyperplasia. American Congress of Obstetricians and Gynecologists.|
|↑18||Von Willebrand Disease (VWD). CDC.|
|↑22||Platelet function disorders. Canadian Hemophilia Society.|
|↑24||Menstruation and the menstrual cycle fact sheet. Office on Women’s Health, US Department of Health and Human Services.|